W^h.ri- *

9 * •

PHYtCt^^'

^^ISitt

OF

N O S O L O G

CORRECTED AND SIMPLIFIED

JS^OMEJVCLA TURE.

BV

JOHN MASON GOOD, M.D. F.R.S.

MEM. AM. PHIL. SOC. AND F.L.S. OF PHILADELPHIA.

^

BOSTON ^

WELLS AND LILLY— COURT-STREET.
1823.

1^

s>-

m *

'i

THE PRESIDENT

FELLOWS

ROYAL COLLEGE OF PHYSICIANS OF LONDON,
THE FOLLOWING WORK i

is
BY THEIR PERMISSION,

AND WITH A DPE SENSE OF THE HONOtTR HEREBY CONFERRED UPON HIM,

RESPECTFULLY DEDICATED,

BT
THEIR OBLIGED AND OBEDIENT SERVANT,

THE AUTHO»| ^

nt.53

f^

41

•^ ♦

PRELIMINARY DISSERTATION.

The foll(wing work was commenced, and its general outline
laid down^'as early as the year 1808, though the pressure of
professional and other engagements has prevented its comple-
tion tjlit now. The interval, however, has not been entirely
tirrotVTi away, for the author has endeavoured to keep his eye
open to every publication or hint that has since appeared on
tfie subject, or has had any connection with it, and has availed
himself of whatever he has found most valuable or interesting..

The main object of the present attempt is not so much to in-
terfere with any existing system of nosology, as to fill up a
niche that still seems unoccupied in the great gallery of physi-
ological study. It is that, if it could be accomplished, of con-
necting the science of diseases more closely with the sister
branches of natural knowledge; of giving it a more assimilated
and family character ; a more obvious and intelligible classifi-
cation ; an arrangement more simple in its principle, but more
comprehensive in its compass ; of correcting its nomenclature,
where correction is called for, and can be accomplished with-
out coercion ; of following its distinctive terms as well upward^s
to their original sources, as downwards to their synonyms in
the chief languages of the present day ; and thus, not merely
«f producing a manual for the student, or a text-book for the
lecturier, b^t a book that may stand on the same shelf with, and
form a sort of appendix to, our most popular systems of natu-
ral HISTORY ; and may at the same time be perused by the clas-
sical scholar without disgust at that barbarous jargon, with
which the language of medicine is so perpetually tesselated ;
and which every one has complained of for ages, though no
one has hitherto endeavoured to remedy it.

The present, however, is but an attempt towards what is
wanted, and is only offered in this view. How far such an
attempt may be worth encouraging, and by what means it may
be conducted towards a desirable degree of perfection, may
perhaps be best determined by a brief glance at the chief no-
sological systems of the daji, the nomencioture in ac^Luse,
and the general nature of the improvement propose^E«he
ensuing volume. It is the aim of this introduction t^Wier a
few hints upon each of these subjects. "^

Vlll PRELIMINARY DISSERTATION.

SECTION I.

N080L0GICi.L SYSTEMS.

1. No art or science can be acquired, for none can be clearly
treated of or communicated, without arrangement. All noso-
logical works, therefore, possessing any value, have an arrange-
ment, or method, as it is called, of some kind or other; and
which it will answer our present purpose to consider as reduci-
ble to two, those of synopsis and of system. In the synoptic
method the whole of the subject is seen by the writer at the
time of his arranging it, as indeed the term imports, and radi-
ates in loose but diverging lines from a point given by his own
genius or inventive power. In the systematic method, the whole
of the subject is, from the first, conjunctively and consonantly
examined, for such is the radical meaning of the term system, and
rigidly distributed into subordinate divisions, agreeably to the
laws of similitude and discrepancy : so that every component
part must necessarily occupy a definite station, as soon as the
governing divisions of the system are laid down. The first
arrangement proceeds usually by parts, books, chapters, and
sections; of which Celsus has furnished us with a very beauti-
ful example ; the second, by a much stricter device of some
other kind ; commonly, after the botanists, that of classes, or-
ders, genera, and species ; and, in consequence of such greatel*
strictness, it better calculated to assist the memory.

Upon the synoptic method it is not the author's intention to
touch ; the systematic has so many advantages over it, as
well in learning as in retaining a subject, that it has long taken
the lead wherever it has been found capable of adoption, and
especially in several of the practical branches of physiologi-
cal science, as zoology, botany, and mineralogy; to which we
may soon hope to add chemistry, though many of the facts of
this last study are still too isolated, and the results of many of
its experiments too disputable, to enable us to employ the sys-
fcmatic method here with any great advantage at present.

It is under this form, therefore, that nosology has been
chiefly taught for nearly a century ; and as the systematic ar-
rangement admits of several modifications, every modification
has been tried in its turn, and has found its admirers. The
simplest systematic modification, if it be in any way worthy of
thej|gMjae, is the alphabetic^ of which, in the present day, we
ha^SB|ny copious examples, highly valuable as works of easy
lefei^Ke, though scarcely enti'tled to rank under the charac-
itcr oT systematic arrangement. To this classification belongs

PRELIMINARY DISSERTATION. iX

the very excellent and important work of Dr. Heber3en. An-
other modification which has been had recourse to is that of
the duration of diseases^ as divided into acute and chronic ; it is
a modification of considerable antiquity, and has descended to
us in the works of Arelaeus, and of Cselius Aurelinnus. A third
modification has consisted in taking the anatomy of the animal
frame as. a ground-work for divisions ; and consequently in as-
sorting diseases, as has been done by Jonston, Sennert, and
Morgagni, and since been recommended by Dr. Mead in his
Medical Precepts and Cautions, into those of the head, chest,
belly, limbs, and almost every other part. A fourf'^ invention
has fixed upon the supposed causes of diseases ao a basis of
distribution, and to this has been applied the epithet e.'?'o/ogica/,
from the Greek term ««t<«, a cause ; it has acquired more popu-
larity than any of the preceding, and was especially embra-
ced by the schools of Boerhaave, Riverius, and Hoffman. Some-
times a mixt modification has been attempted, as in the nosolo-
gy of Dr. Pdacbride, who takes exttnt for his first two general
divisions of diseases, as being universal or local, sex, for his
third, and the age of infancy for his fourth and last. And some-
times, and far more generally of late years, the nosological
system has been built upon the distinctive symptoms of diseases
— the peculiar marks by which they identify themselves, and,
so to speak, become individualized : and such is the principle
adopted by Sauvages, Linneus, Cullen, and all the most cele-
brated nosologists of recent times.

This last is, in effect, the only method in any degree worthy
of attention ; for it is the only one that will generally hold true
to itself, or on which we can place any dependance. Of the
seat of diseases we often know but very little ; of their causes
far oflener still less; but there are certain marks or characters
in the usual progress of most diseases which uniformly accom-
pany and distinguish them, and to which, therefore, the epithet
pathognomic has been correctly applied. It is not, indeed, to
be contended that these distinctive signs are as constant &nd,
determinate as many of the distinctive signs that occur in zoo-
logy or botany. So complicated is the animal machinery, so^-
perpetually alterable and altered by habit, climate, idiosyn-
crasy, and the many accidental circumstances by whiq^yfHlft is
diversified, that the general rule must admit of a varietj:^l?^ex-
ceptions, and is here, perhaps, rather than anywhere elserbest:
established by such exceptions. "Yet, after all, every distinct
disease, occur where it may, and under what peculiarity of
constitution it may, proves so generally true to its own course,

R

X PRELIMINARY DISSERTATION.

and is so generally attended by its own train of symptoms, or
coincidents, which is the literal reaidering of symptoms* that he
who steadily attends to these, will not often be greatly deceiv-
ed, and if he should be, he can find no other guide to set him
right.

The symptoms of a disease, indeed, have not unfrequently
been said to constitute the disease itself. This is not perhaps
strictly true ; they are rather an algebraical character desig-
nating an unknown quantity, but which, in the hands of a skil-
ful mathematician, may be managed as readily in working a
proposition as if such unknown quantity were a sensible object.

It is hence that the writings of Hippocrates and of Sydenham
are so highly and deservedly esteemed ; and will be so as long
as medicine shall be practised. In their hypotheses they are
often erroneous : but they seldom indulge in hypotheses, and
we do not look to them for their speculations, but for that which
peculiarly characterises their pages, a clear and intelligible
statement of symptoms, a valuable history of pathognomic facts.
Celsus, though his plan is more general, is also in this respect
highly entitled to praise ; it is by attending to the perspicuous
description he has given us of the leading features of some of
the diseases he has delineated, that we have been best able, as
will be shown in the progress of this work, to restore his text,
in various instances, to its original purity and correctness, and
to rescue it from the obscurity or nonsense in which it has been
involved by the blunders of copyists, who have occasionally
mistaken one name for another, or filled up lacunae, produced
by the devouring tooth of time, with their own erroneous con-
ceits.

II. Plater may be regarded as the morning-star that first
glimmered in the hemisphere of sjmiptoma! ology, as Serveto
was in that of the circulation of the blood. The light of both
was feeble and tremulous; but it twinkled in the midst of dark-
ness, and led on to the brightness of day. .His work, entitled
Praxis Medica^in which he gives an imperfect sketch of a symp-
tomatic plan of nosology, was published in 1602. Sydenham,
if he did not avail himself of it, was actuated by the same quick-
ening spirit, for his various treatises and epistles, published for
lhc«|(ftst part miscellaneously, are a practical comment upon
Plate^ princijile, and seem chiefly to have stirred up the well-
stored* and comprehensive mind of Sauvages, who was peculiar-
ly atthched to Sydenham^'s opinions and practice, whom he is
continually, praising, and whom he distinguishes by the name

*' l-jf/.TTTafAArct from <ruurrtrrrai, f'to fall in, happen tojiethcr, or coincide."

PRELIMINARY DISSERTATION. XI

of Anglus Hippocrates* to that full illustration of the sympto-
matic method which has given form and being to almost every
attempt that has since appearred upon the subject. Sauvages
first published the outlines of his plan in 1731, in a duodecimo
volume, under the title of J^ouvelles Classes de Maladies, after
having submitted his intention to the judgment of Boerhaave.
This precursory sketch descended no lower than to the divi-
sion of genera ; but having been encouraged to persevere, he
laboured on the species, and introduced ihem in their proper
succession into a new and more extensive edition of his work,
published in 1763, in five volumes octavo ; and continuing his
exertions yet further in the same vineyard, he put his finishing
hand to the great task he had undertaken, by preparing a still
more complete and final edition, which he did not live to pub-
lish, but which was given to the world shortly after his death,
in 1768, in two large volumes quarto.

III. The NosoLOGiA Methodica, for such is the title of M. de
Sauvages's work is, indeed, an Herculean labour. It consists,
in its latest and most perfect form, of three distinct arrange-
ments— a symptomatica!, an etiological, and an anatomical ; so
as to accommodate itself to the taste of the old school as well as
of the new. The symptomatica!, to which the others are pro-
fessedly subordinate, is by far the most extensively elucidated ;
and comprises ten classes, (each introduced by an elaborate
pathological synopsis) upwards of forty orders, more than three
hundred genera, and an almost innumerable host of species. Quel
nombre prodigieux rf' cnncmis ! exclaims M. de Ratte, alluding to
this vast muster, in his elogy on the author, delivered before
the Royal Society of Sciences in Montpellier ; or rather allud-
ing to the somewhat smaller muster of the preceding edition,
for the last was not then published. We have j^et, however,
to add the varieties, which under several species are not few ;
and to bear in mind that to every variety, species and genus, as
far as their relative characters will allow, are allotted a defini-
tion, list of synonyms, history, diagnosis, prognosis, and mode
of cure ; with, frequently, an exemplification of cases, and a
brief statement of the peculiar opinions of other writers, before
we can fairly appreciate the entire mass of matter with which
the volumes of M. de Sauvages abound. He seems, indeed, to
have been desirous of collecting materials of every kirigW^nd
quality from every quarter to which a market was ope^ and
' -- -^.

* Nosol. Method. Piologom. I. 19. See especially the closing paragraph in his
Prolegomena, in which he particularly adverts to the labours botlr. of Plater air'.
Sydenham.

Xll PRELIMINARY DISSERTATION*;

of following-up every deviation from health into all its possible
as well as its actual shades and ramifications, so that no man
might have to add a syllable to his work after him.

It is not very surprising, therefore, that a work .thus consti-
tuted and conducted should be considerably too diffuse. This
is its leading error ; yet it is a venial one, and was by no
means destitute of advantage at the time of its commission ; for
the very amplitude the work evinces rendered it, when first
completed, a sort of nosological bazaar, to which every one
might have recourse who was in pursuit of this new branch of
study : and where he might accommodate himself with what-
ever articles he stood in need of.

In reality, notwithstanding its redundancy — notwithstanding
its occasional want of discrimination — the errors that are too
frequently to be found in its pathology — the looseness of its pri-
mary divisions, and the repetition of several of its species under
different genera — the Nosologia Methodica is still a work of
so much general merit and utility, that the student who neglects
to read it, and even to read it carefully, neglects one of the
most important parts of his education, and which he cannot
well supply from any other quarter. It is, moreover, a work
of considerable elegance ; perspicuous in its descriptions, grace-
ful in its style, and with the exception of several writers of our
own country, and two or three of Italy, purer in its Latinity
than perhaps any medical book of modern times written in the
same tongue ; and is one of the very few volumes we can still
read with pleasure after a perusal of Celsus. It is a singular
circumstance, and to notice it is due to the female sex, that for
much of the grace and purity of his Latin, M. de Sauvages was
probably indebted to a learned Neapolitan lady, the celebrat-
ed Mari-Angela Ardingheii, one of the first scholars and math-
ematicians of her day. He expressly admits his obligations to
her upon this point, in respect to his Medical Commenlarks, i\nd
this too when she was not more than sixteen years of age. —
" Siyli tui gratiis, musarum floribus, meos de febrc, de inflam-
malionc, et de ha^mastica commcntarios hac tctate adornasti :"
— and as he selected this lady for the patroness of his Nosolo-
gy, dedicated it to her, and had an earnest desire that she should
translate it into Italian, there can be litUe doubt that this work
alsoJ|ad the benefit of the same elegant assistance.

ItiSjbl, therefore, to be wondered at, that the labours of M.
dc Sauvages should have made a strong impression upon the
scicntirtc world, and especially upon the medical community.
Linneus, who was at this. period carrying forward his systen^

*r

PREtWlINARY DISSERTATION. XlU

of botany to a perfection that leaves litttle to be wished for,
cultivated his acquaintance from the first ; and the new " Me-
thodic JVoso/ofifi/" became so popular in every quarter, that there
was scarcely a pathologist of any eminence for learning who
did not eagerly study it, embrace its general principles, and
endeavour, by different modifications, to clear it of its imper-
fections, and work it into a more finished form. And hence
the successive attempts of Linneus at Upsala,* Vogel at Got-
tingen,t Cullen at Edinburgh,! and Sagar at Igla\v,§ in Mora-
via : and hence the strong and ardent hope expressed by Gau-
bius, that nosology was now on the point of dropping its loose-
ness and uncertainty, and of entering into the list of strict sci-
ences. And it is highly creditable to the liberality of M. de
Sauvages, and offers an example which ought never to be lost
sight of, that instead of being mortified at the numerous altera-
tions introduced into his system in various countries, and con-
templated in many more, he availed himself of several of them
in the last edition of his work, and will be found often advert-
ing to others, and especially to those of Linneus, with the ut-
most urbanity and deference.

Yet notwithstanding this succession of labours, the subject
was far from acquiring the periection of which it was supposed
to be susceptible ; and we have hence had a still greater num-
ber of attempts at improvement by physicians of the first char-
acter and reputation in their day, of whom it may be sufficient
to mention Selle of Halle, Macbride, Plouquet, Darwin, Crich-
ton, Pinel, Parr, and Young.

To the time of Cullen the general outline or classific ar-
rangement of Sauvages was left without much disturbance ; for
although the order of succession was changed, and changed
differently in every new attempt, the names, in a few instances,
diversified, and occasionally some addition made to the num-
ber, still the ten Sauvagesian classes were substantially retain-
ed and adheredto. These classes are as follow :

I. ViTiA (Cutaneous Affec- III. PHLECMASiiE.

tions.) IV. SrASMi.

II. Febres. V. Anhelationes.

* Genera Morborum, first published by a pupil of Linneus in 1759, and^jfter-
wards by the author in 1763. Ujjsal. 16 pp. jj^T

t Dejinitiones Generiim Morborum. Getting. 1764, 8vo. •'

% Synopsis J^osologia Me thodica. Edinb. 1769, improved by several. Igter edi-
tions, particularly those of 1780 and 1785, which contains, for a comparison, the
systems of Sauvages, Linneus, Vogel, Sagar and INIacbride.

^ Sijslcnia. Morborum Systemalicam. Vienntf, 1771 and 1776.

Xiv PRELIMINARY DISSERTAT!^-.

VI. Debilitates. Morosities of the stomach.)

VII. Dolores (Local Pains.) IX. Fluxus. ,

VIII. VesanijE (including X. CACHExiiE.

The ten classes comprise forty-four orders, three hundred
and fifteen genera, and about two thousand five hundred spe-
cies ; being rather more than an average of eight to each genus.
A few words may suffice to point out the nature of the im-
provements which have been chiefly attempted upon this sys-
tem.

IV. In LiKTNEUS, while the above classes remain substantial-
ly the same, their order of succession is varied, the names con-
siderably altered, apparently from a preference of Latin to
Greek terms, (as in the use of mentales for VESANiiE, motorii
for sPASMi, and deformes for cachexia) and the list of classes is
increased to eleven, by advancing the exanthematic^ of Sau-
vages, which in him occurs as an order of phlegmasia, to the
rank of a distinct class; while the class vitia, with which Sau-
vages opens, is by Linneus thrust to the end of the series.
The Sauvagesian genera are not much interfered with in re-
spect to number. Upon the whole they are rather extended,
and amount to three hundred and twenty-six. The generic
names, however, are occasionally altered ; and the definitions,
■which are formed by an almost constant reference from one
genus to another, are necessarily drawn up in very different
terms, in order to quadrate with such a change. Some degree
of abbreviation is unquestionably hereby produced, which is
always desirable when accompanied with perspicuity. But
there are few cases in which, the author has not preferred the
definitions of Sauvages, though frequently too diffuse ; for the
perpetual aim at brevity in Linneus leaves him too general
where he has not occasion to refer to other diseases, and too
perplext and intricate where he has. The table of Linneus's
genera does not comprise his species; but it is well known that
in these he adhered with considerable closeness to Sauvages.

V. The great object of Vogel was to supply what he con-
ceived to be omissions on the part of Sauvages: and hence he
gives a muster of not less than five hundred and sixty genera,
being nearly double the number of his great prototype. But
to accomplish this he has been compelled to elevate to the rank
of gSfera a great multitude of affections which ought only to
be confemplatcd as species, many of which are merely symp-
tomatic of other diseases, and not a few, as risus,fietus, suspi-
rium^ clamor^ (some of them, indeed, derived from Linneus,)
which have no claim to be regarded as diseases at all. In his

PRELIMINARY DISSERTATION. XV

classific arrangement, while he takes Sauvages for his guide, he
changes the line of succession as considerably as, though in a
different manner from, Linneus. He degrades the exanthema-
Tici of the latter from a classific post, and introduces them as
well as the phlegmasia of Sauvages, as mere orders, under his
class FEBRES. Hc unitcs into one class the anhelationes and
DEBILITATES of Sauvagcs, under the name of adynamije ; and
having thus reduced the number of the Sauvagesian classes to
nine, he raises them to eleven by the creation of two new
classes, which he calls hyperastheses, and depormitates : the
former, properly enough, separating Sauvages's morosities of the
stomach from genuine mental disorders, and the latter including
external deformities of a prominent character. His defini-
tions are peculiarly concise, but convey too frequently nothing
more than general and indistinct ideas : while his new-created
terms are peculiarly long and cacophonous, as in the words hy-
pospadioios, dionysiscus, and hyperartertiscus. For his species
and varieties, or rather those he has not elevated to a higher
rank, he seems, like Linneus, to have depended, for the most
part, upon Sauvages.

VI. The system of Sagar makes less deviation from that
of Sauvages than either of the preceding : and may be regard-
ed rather as an enlargement, than a remodification of it. In
various respects, indeed, it alters the series of succession, but it
retains the name of every class ; though it increases the num-
ber from ten to thirteen, by advancing the Sauvagesian orders
of PLAG^ and EXANTHEMATic^ to the rank of classes, and by in-
troducing a new class, denominated suppressiones, designed to",
correspond with a considerable part, though not the whole, of
the suppressorii of Linneus, as Linneus intended this last to
correspond with a considerable part, though not the whole, of
the anhelationes of Sauvages. His definitions are mostly
taken with little variation from Sauvages, but are rendered inr
tolerably long by confounding Sauvages's generic characters
with his generic descriptions, and running the two together: so
that instead of eighteen or twent}^ words, which is, perhaps, th^
utmost that ought to be allowed, and more than the Linnean
canons permit in botany, we have sometimes upwards of a hun-
dred, filling an entire page, as in rubeola, whose definition, if so
it may be called, extends to a hundred and ten lines ; ^nd in
aptha, which employs a hundred and thirteen. He is loss re-
dundant in the number of his genera than Vogel, though he
makes a boast of having extended them to three hundred and
fifty-one. It would have been better for him. as Cullcn o>,'-

XVI PRELIMINARY DISSERTATION.

serves, lo have boasted of having exercised, in stn equal degree,
his power of compressidh. The system of Sagar is rendered
more complete than either Vogel's or Linneus's by being filled
up with his species. These, however, are de^duced, with occa-
sional alterations, from Sauvages, and exhibit the same verbo*
sity as his genera.

Upon the whole it does not appear that the Nosologia Me-
THODicA of the Montpellier professor royal was much benefited,
either in its arrangement or its substance, by any of these
three attempts at improvement ; while, in various respects, it
was, perhaps, rendered less commodious and useful.

Vll. Such was unquestionably the opinion of Dr. Cullen,
with respect to the two former of these — for that of Sagar was
not then before the public — when he first thought of essaying
his own powers in the field of symptomatic nosology; and
hence, notwithstanding the later models that were before him,
he resolved upon once more taking for a basis the original ex-
emplar.

The first objection, however, to this exemplar, which he
seems to have felt, was not the mere series, but the nature of
its classification. The main object he proposed to himself, and
a more important he could not lay down, was that of "brevity
and simplicity ; and the Sauvagesian classification offended in
both respects. He determined, therefore, upon changing it,
and recasting the system from its commencement. Instead of
ten classes he conceived that four alone might suffice, formed,
as he proposed to form them, of a calibre capacious enough to
swallow up all the rest. He moulded his four classes accord-
ingly, and distinguished them by the names of

T. Pyrexia, III. CachexijE,

II. Neuroses, IY. Locales:

and, influenced throughout the whole of his reform by the same
spirit of simplicity and concentration, he reduced the forty-four
orders of Sauvages to twenty, and his three hundred and fifteen
genera to one hundred and fifty-one. He next carried his prun-
ing hook into the field of species : some he found to be repe-
titions of the same disease occurring under different genera,
and others mere symptoms of other disorders, instead of dis-
tinct o^ idiopathic affections ; all which were steadily lopped
off"; indr^in this manner the reduction in the species bore an
equal proportion to that in the genera. The genera and spe-
cies that remained were next enlisted into his own service,
mostly with the respective names assigned them by Sauvages.

PRELIMIISARY DISSERTATION. XVll

though the definitions were generally re-composed, and appa-
rently modelled in consonance with tl^^ reformer's own practi-
cal observations. .

Thus completed and fit for use, the new system was first
started in the largest medical school of Europe, its author pre-
siding at the head of it. It is'ndt, therefore, surprising that it
should instantly have rushed into popularity, and become a
subject of general approbation. Yet it did not stand in need
of this adventitious support to introduce it to public favour.
Its aim at simplicity, as well in extent as in arrangement, was
noble, and bespoke correct views, and a comprehensive mind ;
it promised a desirable facility to the student, and a chaste
finish to the architecture of the nosological temple. The author
showed evidently that he had laboured his attempt in no ordi-
nary degree ; and many of his definitions discovered a mastery
that had never before been exemplified : pictures painted to
the life, and of proper dimensions.

To this extent of praise Dr. CuUen's system is fairly entit-
led; an extent which ought ever to be borne in mind amidst
the numerous, and, in many instances, exaggerated exposures
of its defects which have lately been exhibited, and which it
seems to be a growing fashion to detail both at home and
abroad ; more especially in Germany, where it has been as-
serted, ex cathedra, and believed by extensive audiences, that,
after all his pretensions, Cullen has done little or nothing for
the improvement of nosology.

That the system, nevertheless, has faults, and insurniounta-
ble ones, it would be absurd to denj' ; for they meet us at the
very outset, and run through the whole of its texture and con-
stitution. It is sufficient to notice the three following : 1. De-
fective arrangement. 2. Want of discrimination between ge-
nera and species. 3. Looseness of distinctive character in the
last general division.

1. Of the four classes adopted by Dr. Cullen, the first two,
PYREXIA and NEUROSES, have considerable merit, and this merit
is exclusively his own. Each term suggests to the mind at
once a peculiar group of diseases, of sufficient range for a lead-
ing division, and occupies a province possessing a sort of natu-
ral outline, or arrondissement, as the French chorographers de-
nominate it ; in which, if the boundary occasionally fail or lose
itself in the adjoining provinces, it is easily supplied by the
hand of art. At times, indeed it seems difficult under such a
system, not to overstep the natural boundary imported by these
"terms in their common use, and, like the late ruler of France,
^: ■ f

Xviii PRELIMINARY DISSERT ATIOSf.

to give in many parts a broader and an altogether artificial
outline by the invasion of adjoining districts; and, from the
paucity of his classes, Dr. Cullen has frequently found himself
compelled to such a transgression, and has alfbrded us a pal-
pable instance of it in the very class with which he commences;
lor the tribe of il^morrhages,' which forms one of its orders,
have no direct catenation with:any idea suggested by pyrexy
in the common use of the term; they require coercion to bring
them into a state of union ; and, what is still worse, Dr. Cullen,
with all the force he could employ, has found himself incapa-
ble of coercing more than one half of them ; and, consequently
has been obliged to leave the other half behind, or rather to
banish them for contumacy to the extreme region of his fourth
class. So that in his system they exhibit a wide and lamenta-
ble divorce, and afford a striking and perpetual memorial of
the tyranny which pervades it in spite of its attractive exterior.

Still, however, the first two classes are substantially good:
and have in some shape or other been copied by almost every
succeeding nosologist. The third class has also a claim to
attention, though the term cachexia, by which it denominat-
ed, has been used, and still continues to be used, in sen-
ses so extremely diflerent by difterent writers, that it by no
means suggests to the mind a connected group of diseases, with
the same readiness q.s py rex iie or neuroses. As a class, indeed,
the division of cachexias occurs in all the preceding writers,
with the exception of Linneus ; and so far Dr. Cullen can plead
authority; in Linneus it is reduced to a genus, and in Vogel it
IS given v/ith singular imprecision, both as a class and a genus,
distinguished by a mere difference of number. Under every
WTiter, however, the term is employed in a various sense ;
sometimes importing depraved external colour alone; some-
times depraved colour and form ; sometimes depraved colour,
form, and size ; and sometimes, as in Cullen's definition, de-
praved habit of the whole or a great pai-t of the body, without
any notice whatever of the preceding (jualities. Were we to
pursue this subject, and it will be necessary to do so hereafter,
wc should find that among later writers it has been employed
with a still wider difference, till at length by several of the
most intelligent it has been banished altogether, from the inex-
tricable confusion that has been heaped upon it.*

Vet by far the most faulty and incorrigible part of Dr. Cul-
len's arrangement consists in his last ilivision or class locales.

' See note oirpTSTit.'ETirA, cl. iv. orcl. iv.

P.^f.lMIN>^Ry DISSERTATION. XIX

y ' ' '....■

It has no scientific relation to the pf ececling classes — no paral-
lel or apposition with them. To have brought it into any such ^
kind of bearing, the 'whole of the former should have been de-
nominated conjunctively universales, as has been done by Dr.
Macbride. But this would have destroyed the general casting
of the arrangement, and have produced a division which was
not wanted, and perhaps does not exist.* It must be obvious
to the slightest observer that the sole object of this class is to
form an appendix to the three preceding, for the purpose of
receiving, like the cryplogamia of the botanical system, such
genera as the foregoing classes could not be brought to include.
Crvptogamia, however, from its name and capacity, is altoge-
ther adequate to its intention : it is a double objection to lo-
cales that, while the term stands isolated and without relation
to its fellow terms, its intrinsic and essential idea (that of parti-
cular part or place) creates an insurmountable bar to the re-
ception of a great proportion of the genera which it is directly
intended to comprise. In consequence of which the whole
scheme, as a scientific system, is rendered nugatory; it shuts a
door upon its own community; and the rejected diseases wan-
der about from class to class, trying in vain for an entrance,
like the wretched ghosts of the idle and the inglorious in the
Inferno of Dante, who did neither good nor harm while on
earth, and who are in consequence debarred all admission both
into heaven and hell, as having no direct charactA- for either
place ; "

Cacciarli i Ciel, per non esser men bello ;
Ne lo profondo Inferno gli riceve.

Of these diseases, therefore, Cullen has been obliged to give
a list at the end of his synopsis, under the title of " Catologus
Morborum a nobis omissorum, quos omississe fortassis non opor-
lebat:" and has thought himself called upon to offer an apology
in his Prolegomena. " These omissions," says he, " I confess
and regret; but various reasons operated to the omission of
some diseases. In the first place it must be acknowledged that
several utterly escaped our attention. Next, there are others,
sufficiently known^for which a Jit place cannot he found in our sys-
tem. And, lastly, there are others whose history among medi-
cal writers is so imperfect, that no fit place or character can
be assigned to them."t ^

— : _ : A_

* See Clutterbuck's Inquiry into the Seat and Nature of Fever. Ch. Klsert, iii.

t Hujusmodi omissiones agnosco, et quidem doleo ; sed variae rationes, ut qui-
dam morbi hie omitterentur, effecfrunt. Primo fieii potest, ut quidam observa-
tionem nostram penitiis elfugerint; dein sunt alii satis noti, quibus in nostro syste-

XX PRELIMNARY DISSERTATION

It is with the second of "these apologies alone that we have
any concern at present, for time and stricter attention may
overcome the evils to which both the others relate. But the
utter want of fit places for well known diseases in a nosological
system, and this too in the opinion of the author of the system,
is a defect from which no time or labour can ever relieve it.

Dr. Cullen, however, it must be admitted, has been as inge-
nious as he could ; and contrived the means of giving through-
out all his classes an entrance to diseases that have very little
claim to admission. But the consequence is, that they make
a sad medley, and in many cases have not the slightest affinity
or family resemblance; of which we have a striking example
in psora and fractura, which follow in immediate succession in
the class of local disorders. Psora (itch) can scarcely be call-
ed a local affection, unless the term be appropriated to the skin
generally, as distinguished from all the other parts of the frame ;
but in this case trichosis and lepra should have been placed in
the same class, instead of in that of cachexies ; while fractura
could have no pretensions to such a class unless when com-
pound. But it must certainly puzzle the best medical scholar
in Europe, who is not acquainted with Dr. Cullen's arrange-
ment, to discover the least connexion between itch and broken
hones, and especially such a connexion as . not only to draw
them into the same class, but to make them immediate neigh-
bours in the same order. Dr. Cullen, however, has ascertain-
ed that they are both local disorders, which entitles them to a
common class, and both dialylic disorders, or produced by a
division of continuity, which entitles them to a common order:
and hence to the question, " why is the itch like a broken
bone?" the student's answer is, "because it is a dialysis:" an
answer somewhat wanting perhaps in professional gravity, but
the only one that can be given. And here it is probable we
must stop ; for there seems no possibility of advancing farther,
and assigning any reason for the very close intimacy allotted
to psora and fractura by fixing them in immediate succession.
Yet there is perhaps quite as much difficulty in determining
what could be the author's motive for placing nostalgia in any
part of the same class.

2. It is impossible to take a survey, however brief, of Dr.
Cullen's system, and not to notice his very extraordinary con-
fusion.pf genera and species. And the author is the more in-
mate, locus Idoneus nusquam inventus est; denique, sunt alii quorum historia,
apud medicos adeo sit imperfecta, ut ncc locus iiec character idoneus iis nssignari
tjueat. Prolegorn.

PRl^LlMIXARY DISSERTATIOiSr. XXI

duced to advert to it, because,' extraordinary as such a confu-
sion must appear to all who are acquainted with the difference.
Dr. CuUen is by no means the only nosologist of our own day
Avho has run into the same mistake, as will easily be perceived
before the close of this dissertation.

A genus is not a disease^ any more than it is an animal, a
vegetable, or a mineral; but a group or assemblage of any of
these, possessing certain like characters, and associated in con-
sequence' of such resemblance. The consenting characters
being abstracted and put tog6the^, constitute the generic defini-
tion, and apply to the whole ; while the subordinate characters
or coincidents, by which one differs from another, constitute
the specific definition, and distinguish 1 from 2, and 2 from 3,
of the same group or genus. A genus, therefore, is a mere ab-
stract term, a non-entity in nature ; highly useful, indeed, in the
chain of orders, — but which can no more exist without species
than a regiment or a regimental company can exist without
soldiers. On this account it is that no man can ever discover a
genus, though he may combine generic signs, and invent a ge-
neric name. The usual order is the following: he first disco-
vers an individual, whether a plant, animal, or disease, possess-
ing very peculiar marks, so as to separate it distinctly from
any known individual, or groups of individuals. He may now,
therefore, be said to hav6 found a new species ; and he pro-
ceeds next to arrange it. He first separates from it the most
striking mark by which it is distinguished ; and if this should
be strictly singular, it constitutes alone a sufficient character for
a new genus, and will form what is called, from this very cir-
cumstance, its essential generic character. If it be not strictly-
singular, he must look for another striking character, — a coin-
cident or co-appearance, — or if necessary, in order to render
the distinction complete, a third ; and the generic character
will consist in the union of these co-incidents, in the combina-
tion of the marks that are thus first detached from the indivi-
dual, and then brought into a state of combination. To this
combination of detached or abstract signs he gives what name
he pleases; and he thus obtains a generic name as well as a
generic definition. He then proceeds to select one, two, or
more other marks, by which the individual is peculiarly distin-
guished ; and these united form his specific definition, lo which
in like manner he adds a specific name. He has nOTsr disco-
vered and identified a species, and formed and denominated a
genus. His genus, indeed, consists at present but of a single
species; and many genera never consist of more: but the ge-

XXll " PRELIMINARY DISSERT ATIOl^'.

nus is, nevertheless, formed upon a collective principle; it pre-
. supposes that other individuals may .hereafter be detected pos-
sessing the same generic character, and consequently belong-
ing to the same banner ; at the'same time differing in several
of its subordinate marks from the indivitiuals already arranged
under such banner; and which in consequence will produce
new species as long as other individuals possessing such discre-
pancies shall be traced out ; unless, indeed, should the discre-
pancies be found to be casual, to depend upon soil or food, up-
on climate, atmosphere, position, or some other incidental cir-
cumstance; and in such case the individual is regarded as a
mere variety of some species described already.

The writer, therefore, who describes a genus that has no
species belonging or subjoined to it ; or who gives a generic,
without a specific, name, describes a mere abstract form, a
thing that has no existence without the addition of other signs
or qualities which do not enter into his definition ; and which,
in relation to the individual, constitute the most important part.

Now the present charge against Dr. Cullen is, that while in
some cases he has given genera with the proper species be-
longing to them, in others he has given genera without any spe-
cies whatever ; and in others again that he has described spe-
cies under the name of genera.

As instances in which he has adhered to a regular system-
atic precision, we may take phlogosis and cynanche. To the
first are allotted two species, 1. phlogosis, Phlegrnone : 2 p.
Erythema. To the second are allotted five species; and it
affords one of the most excellent specimens in the entire scheme,
of perspicuous description, and accurate discrimination ; though
it may admit of a doubt whether sp. 5 might not more correctly
be arranged under another genus. The five species are as fol-
low : 1. cynanche tonsillaris : 2. c. maligna : 3. c. trachealis : 4.
c. pharyngea : 5. c. parotidea.

Of a want of systematic precision the examples are very fre-
quent in every class. Thus sy nocha, synochus, hectica,phrenitis,
hepatitis, and many more, afford instances in the first class ;
hypocondriasis, chlorosis, and others in (he second ; polysareia,
hydrometra, hydrocele, &c. in the ihii'd ; pica, adi|:)sia, pro-
fusio, and nearly all that follow, in the fourth class. Nor can
it be said, that in these cases we are tacitly referred to the
species ©f Sau\ages for adoption ; since under adipsia we are
cautioned as;ainst using the only one in Sauvages that has any
relation to Cullon's genus ; and in profnsio we have a genus
for which JSauvages has no direct parallel. Tt would be easy

PRELIMINARY DISSERTATION. •. XXUi

to prove that a very consid^TSfble number of these naked gene-
ra are in reality species belonging, or which a very little dex-
terity might make to belong, to another genus; but to follow
up this view of the subject vvQi-tld render this dissertation too
diffuse, and a multitude of exaeiples will be found in the body
of the work. >- .

The author has observedy'thal Dr. Cullen is warmly to be
commended ibr the general example he has set of banishing
the symptomatic species of Sauvages, and the caution he often
evinces in selecting distinctive symptoms for his definitions.
In a few instances, however, he has singularly enough retained
the symptomatic species ; and occasionally, and especially in the
fourth class, has offered characters so general as to be totally
incapable of discriminating the peculiar disease. What sort of
tumour, for example, possessing any distinctive features, can
we embody to our imaginations from the following character,
which is the whole that is communicated to us, " extuberatio
mollis, non dolens?" It may be a varix, a bronchocele, a gang-
lion, a sarcoma, an encystis. in Cullen it is intended to de-
fine a sarcoma. So another genus in the same order, is char-
acterised by the terms, "- extulieratio durior, scabra." But
what is the meaning of durior? we have nothing given us to
compare it with; and consequently, though a chief member in
the sentence, it conveys to us no adequate idea whatever. To
understand it we must read it, as it is intended we should, in
connexion with the genus that immediately precedes it, which
genus happens to be sarcoma, and then we learn that by durior
is meant durior sarcomate. The definition, after all, is not very
clear, and the reader has not yet perhaps guessed that the
words are designed to typify a veruca or wart.

It is not necessary to pursue this investigation further. There
can be no diificulty in conceiving why the distinguished repu-
tation of Dr. Cullen should be incapable of securing to his no^
sological system the popularity with which it was at first greet-
ed : nor why a host of learned rivals, few of whom have
humiliated him by their competition, should, indifferent parts of
Europe, have endeavoured to offer schemes big with the fair
promise of realizing the noble object he had in view, and free
from the defects he has exhibited.

These rival attempts may be summed up in a few words:
for such is the difficulty of the subject, that none of tlfed'have
been eminently successful ; while the greater part have drop-
ped from the cradle into the grave.

XXIV PRELIMINARY DISSERTATION.

VIII. The chief foreign competitors are Selle, Plouquet, and
PiNEL. The first is rather a monogrammist, to borrow a term
from the vocabulary of natural history, than a writer on gene-
ral nosology. His first attempt was confined to the proviiKe
of fevers alone, and appeared at Halle in 1770, under the title
oi '■^ Methodi febrium natural'is Rudimenta :'''' and it was only
to an enlarged edition of this, published at Berlin in 1786, that
he subjoined a specimen of his general classes. They are al-
together theoretical; and as he has not accompanied them with
their respective genera, it would be superfluous to copy the
classification. The cloudiness that hangs over his division of
fevers leaves us without regret that he did not complete his en-
tire scheme. It may be sufficient, perhaps, to observe, that in
his '''■Methodical Pyretology,'''' rheumatism, catarrh, and exan-
thems are included under a single genus.

IX. The "Outlines" of Plouquet furnish a system that wan-
ders less into theory, but which is far too complicated, and cer-
tainly not without its nebulosity. It was published at Tubin-
gen in 1791, in four volumes octavo, under the following title,
" Delineatio Sytematis Nosolos,i(B naturie accomodati.'''' It is singu-
larly distinguished by the author's fondness for long crabbed
words. He made a far better present to the public a few
years afterwards in his " Hints towards a Medical and Chirur-
gical Library," — " Initia Bibliothecae Medico-practicffi, et Chi-
rursiae realis," — extending to seven volumes quarto, in the or-
der of an alphabetical arrangement.

X. To PiNEL, as to Selle, we are indebted for both a mono-
graphic and a general attempt. The first is his well known
■•' Traite Medico- Philosophi que sur V Alienation Mentale ;" the di-
visions of which are clear, and the remarks of high practical im-
portance. The present writer will be found to have availed
himself, as far as possible, of the advantages which this excel-
lent treatise affords. He has not, however, been able to make
the same use of M. Pinel's Philosophical Nosography. It is too
refined for popular use, and too indistinct for practical benefit.
The classes arc as follow: 1. fevers: 2. inflamniations: 3. ac-
tive haemorrhages : 4. neuroses : 5. lymphatic diseases : 6. in-
determinate class for the reception of disorders which cannot
be received into the preceding classes, or whose characters yet
remain to be ascertained. This last division evinces a woeful
want of skill, and is far more reprehensible than the locales of
Dr. CuUen. M. Pinel has, moreover, betrayed a singular itch
for changing established terms which, in many cases, require
no rl.anfo \(hnir"\or • and .«ni)pr<;('dinir them by others which

PRELIMINARY DISSERTATION. XXV

are neither more true to correct theory, nor more euphonoustoa
correct ear. As examples we may notice that inflammatory
fever is here denominaied mfgi-stenic ; bilious fever, meningo-
gastric ; putrid, adynamic ; malignant, ataxic.

.XI. In turning our attention to our own country, we shall per-
ceive that the first attempt tb improve on the Cullenian system
was hazarded by Dr. 'Macbuide. Il was published as early as
1772, and consists of nothing more than a nosological table, em-
bracing indeed the divisions of genera and species (except in
tlie order of vesanise, which is left imperfect, from an indeter-
mination in the author's mind upon this subject) but totally void
of definitions. In the opinion of the writer of these pages this
unfinished sketch is well worthy of attention, and has not had
sufficient justice rendered to it. Its chief failure consists in the
nature of its classes or primary divisions. These consist of four,

UNIVERSAL DISEASES, LOCAL, SEXUAL, and INFANTILE. The SCCOnd,

or local class, is evidently derived from Dr. Cullen, though
the term is employed in a stricter sense : and the formation of
a class of universal diseases follows naturally, and, indeed,
necessarily, from the institution of a class of local. A precise
Jine of distinction, however, can never be drawn by the most
delicate hand ; and it is oln-ious to every one, that the employ-
ment of other classes after these, whatever be their names,
ranges, or attributes, must be absurd 5 for the terms universal
and local necessarily include every disease in nature, and
leave no other distinctive class to be added. Yet Dr. Macbride
appears to have exhibited as nice a skill in the arrangement
of his genera and species, as he has want of skill in his primary
outline. There is a clearness, a neatness, and simplicity, which
the author has endeavoured to avail himself of, wherever the
structure of his own system Would allow, and which he has
often left with regret where it would not. Nothing can more
eflectually show the good taste and liberality of Dr. Cullen,
than his Latin translation and introduction of the first and most
extensive class of Macbride's table, into the last edition of his
synopsis, for the purpose of comparison with his own arrange-
ment, as well as with the systems of those to whom he was most
indebted.

XII. Another table of diseases, distributed under a different
systematic arrangement, was published not many years after
by Dr. Crtchton ; and, like the preceding, unaccompanied
with definitions of any kind. Its classes are eight, consisting
of Cullen's four, with the addition of four others, for the pur-
pose of accommodating those genera which are chiefly under a

D

XXVI PRELIMINARY DISSfiRTATlONy

State of restraint in the CuUenian method ; E^nd to which he
has given the names of HiEMORRKAGik, FLuxus,hNTUMESCENTiiE,
EPiscHESEs. This,, assuredly, offers some improvement, but the
retained class locales is subject to'the common objections against
it ; and in the subdivisions of this class Dr. Crichton has no
reason to boast of being more suc'cessfnl than his predecessors.
He seems sensible, indeed, of the difficulty, and .appears to
shrink from it; for in the fourth, fifth, and sixth orders of the
local class, entitled prolapsus, luxatio, and tumores, he has
withheld his species ; and in the three ensuing orders, entitled,
vuLNUs, ulcus, and FRACTURA,he has equally withheld his genera.
For the most part his generic and specific distinctions exhibit
far less precision than those of Dr. Macbride, whilst he has
most unaccountably restored the symptomatic species of dis-
eases which Cullen laboured so meritoriously to suppress. It
is somewhat singular, therefore, that Dr. Crichton should have
best succeeded where Dr. Macbride principally failed, and
chiefly failed where Mac})ride has been most successful. The
present writer has been under far greater obligations to Dr.
Crichton for his " Inquiry inio the J^alure and Origin of Menial
Derangement^^'' and the i)Osolo:i;ical system, in relation to this
branch of medicine, which accompanies it. The last is a valu-
able improvement upon this division of his general table; yet
it is not a little extrnordinary that, in both, Dr. Crichton should
adhere to the vulgar distinction between mania and melancholy,
in opposition to the concurrent view of the best pathologists.
This treatise, however, is, upon the whole, a truly philosophi-
cal work: comprehensive in its survey, intelligible in its plan,
and richly tesselated with illustrations and the opinions of other
writers.

XIII. There is another system of nosology, published in-
deed some years before Dr. Crichton's, of which it will, per-
haps, be supposed th it some notice should be taken in the
present survey, — though from its bf/ng lounded, not on symp-
toms, but on theory, it might be passed by without blame,
and that is Dr. Darwin's. The author of Zoonomia was a man
of great genius, dnripig imagination, and extensive reading.
Unfortunately for him, he wns perpetually stung with a desire
of distinguishing himself by seeing things, weighing things,
and combining them in a manner diflerent from every one
else. All his works, which the present writer has read atten-
tively, and some of them more than once, give proof of this;
and show evidently that he would at any time rather think
wrong with himself, than think right with other people. And
.hence, while he gffcrs much to gratify, he offers also much to

PRELIMINARY DISSERTATION. XXVU

oft'end ; and prQves that ifhe had aimed at less he would have
accomplished more. His' nosological system is founded upon
his physiological principles ; v^hich, stripped of extraneous
matter, may be told in few. words, so far as they are applicable
to the present subject. .Tii^,j)rAi'''i as a collective organ, is the
fountain of life and sensati6^'^and sends forth fibres of different
kinds and for different.pui'pOses;' which are excited, and com-
municate perceptions to the organ whence they originate, by
four diilerent classes of slimu'li, those of simple irritation, of
sensation, of volition, and of association ; every part of the
animal frame having a greater or less degree of influence upon
every other part, and operating this influence by the medium
of sympathy; in consequence of which, Dr. Darwin was desir-
ous that his own theory should take the name of the sympa-
thetic. " Every u/ea," says he, " is a contraction, or motion,
or configuration of the fibres^ which constitute the immediate
organ of sense ;"* and hence it seems difficult for the friends
of Dr. Darwin to repel the charge, that ideas, under this ex-
planation, must be material substances. Health he contem-
plated as consisting in the natural correspondence, and degree
of correspondence, of the various organs of the body to their
respective stimuli, and disease as an effect produced by any,
even the slightest deviation, from such correspondence in any
part. Hence every such effect^ in his opinion, constituted a
disease; and what is commonly so denominated, and which
consists of a combination of symptoms, as a fever or a colic, he
regarded as a group or bundle of diseases ; a sort of Pandora's
box, where they muster their secret and collective strength,
and whence they issue simultaneously. In forming his noso-
logical arrangement, he made these effects, and the parts or or-
gans in which they manifest themselves, constitute his genera
and species ; while he derived his classes and orders from
their proximate, or rather what upon his theory are supposed
to be their proximate, causes, and the peculiar characters which
these causes exhibit; the number of the classes being four,
derived as may be easily conjectured from the four sources of
stimulation just referred to. " IJi^ve-iciken," says Dr. Darwin^
"the proximate cause for the classic character. The charac-
ters of the orders are taken from the excess, or deficiency, or
retrograde action, or other properties of the proximate cause.
The genus is generally derived from the proximate effect.
And the species generally from the locality of the disease in the
system."! -

*Zoonom. Part I. sect. II. ii. 5, tPreface to ZoonGitija. Part II. --'' .

XXVlll PRELIMINARY DISSERTATION.

By proximate cuuse^ however, Dr. Darwin -does not mean
•what is generally understood by this, phrase, namely, the most
strii<ing or characteristic symptom of a disease ; but what
should seem to be the proximate causo upon his own theory^ and
which in every instance m?/srbe a. different and often a direct-
ly opposite thing. Thus in nictitfJtiori, the proximate':canse^ in
the common sense of the term, is a '^ rapid and vibrating motion
of the eye-lid," which ought, therefore, to constitute the charac-
ter of the disorder. In the vocabulary of Dr. Darwin, howe-
ver, this, instead of being the proximate cause, is the proximate
effect; while his joroximaie cause is "increased irritation," which
is the remote cause, as the phrase is commonly explained. We
are not now inquiring which is the more correct use of the
terms cause and effect, but only pointing out the variance and
the confusion that hence necessarily ensue. The perplexity
hereby produced must have been an effectual bar, had there
been no other, to Dr. Darwin's system ever becoming popular.
Unfortunately there are many others, and of as formidable an
aspect. The entire basis is theoretical ; in several parts vi-
sionary: the whole wa?/, therefore, prove hereafter to be un-
founded; a considerable portion of it evidently ?'s unfound-
ed at present. But iho direct death-warrant of the system
consists in his making every single proximate effect (in com-
mon language proximate cause, or symptom) a distinct disease ;
for as the same proximate effect or symptom may be pro-
duced by several, or by each of what Darwin calls proximate
causes, and which constitute his classes, it follows that the
very same species or specific disease must in such cases be-
long equally to some order or other of several, or of all the
classes of his system. And such, to the student's embarrass-
ment and surprise, he will find upon examination to be the real
fact. Thus while variola (small-pox) is arranged under cl. ii.
ord. I. gen. iii. eruplio varioke (small-pox eruption) occurs un-
der cl. IV. ord. I. gen. ii. So hydrophobia appears first in i. in.
i. and afterwards in iii. i. i. Diabetes in i. in. ii. and again in
TV. III. i. Palpitalion of the heart in i. ii. i. and again in i. in.
iii. being twice in the same class: and so of many others.

Such perplexity sets all the ordinary laws of method at defi-
ance ; yet it is easily accounted for from the nature of the
primary divisions. It is not, however, so easy to account for
Dr. Darwin's introducing into his table of diseases such natural
states or affections as the following: Healing of ulcers, i. i.iii.
Deglutition, n. i. i. Respiration under the same genus. And
the life of an egg, IV.' J. IV. which, from some unaccountable

PREtlMlNARy DISSERTATION. XXIX

fancy, is thus rendered one of the diseases of association.
While, to make the system still more defective and incapable
of practical use, its author has given us neither his specific nor
his generic definitions, excepting, indeed, occasionally; confin-
ing himself entirely to his Latin and English names : and send-
ing us for their descriptions to " the Nojjologia Methodica of
Sauvagcs, and the Sjmopsis Nosologiae of Dr. Cullen, and the
authors to which they refer." But such an appeal can be of
no possible service : the . diseases in Darwin's system do
not run parallel with those referred to, and the descriptions
will scarcely in any instam'.e apply. In some cases, however,
he has made distinctions that do him great credit, and are
highly worthy of attention : and of these the writer has endea-
voured to avail himself.

How deeply is it to be regretted that so much genius and
learning, so much valuable time and labour, and, above all, such
lofty hopes and predictions, should have been productive of so
small a result. It is in these words Dr. Darwin concludes his
last, or supplementary, chapter, of this elaborate work, in which
he unfolds his theory of fever. " Thus have I given an outline
of what may be termed the sympathetic theory of fever, to dis-
tinguish it from the mechanic theory of Boerhaave, the spas-
modic theory of Hofi'man and of Culien, and the putrid theory
of Pringle. What I have thus delivered I beg to be considered
rather as observations and conjectures than as things explained
and demonstrated ; to be considered as a foundation and a
scaftblding, which may enable future industry to erect a solid
and a beautiful edifice, eminent both for its simplicitj'' and utili-
ty as well as for the permanency of its materials : — which may
not moulder^ like the structures already erected, into the sand of
which they were composed; but which may stand unimpaired,
like the Newtonian philosophy, a rock amid the waste of ages.'"*

No generous spirit can read this passage without a sigh ; nor
probably without exclaiming in the words of Mr. Pope :

O, blindness to the future ! — kindly given.

XIV. In the very excellent Medical Dictionary of Dr. Parr,
which has now been about nine years before the public, the
reader will find, under the article nosology, a systematic ar-
rangement of diseases which ought by no means to pass without
notice in the course of the enquiry before us. Of Dr. Parr
the present writer can only speak in terms of high consideration
and regard. He was his colleague in conducting^'for some years,,
two of the most extensive literary \^To^ks of the present xl^y,

XXX PRELIMINARY DISSERTATION.

■ ■ ' <>.
though not the Dictionary in question ; and he can affirm, from
a full knowledge of his talents, that he was a man of deep
study, comprehensive capacity, and extensive learning. His
mind, indeed, was so widely fnnight with miscellaneous in-
formation, lh;il few sulijecis could come amiss toi)im. His
Dictionary gives evident proof of liis having been alive to every
novelty in his own profession, and of his readiness to allow its
merits. He was far more disposed, indeed, to be satisfied with
the opinions of others than with'those of himself; and chiefly
failed in a want of deference to his own judgnient. In laying
down the outline of his system of diseases, which he only at-
tempted upon a full conviction that a work of this kind wa*
extremely wanted in the medical republic, he had his eye
chiefly directed to the nosological method of Selle, and the bo-
tanical method of Jussieu. It follows, therefore, that his pri-
mary division would consist not of classes, but of what he in-
tended to be, natural orders or families. These orders are
twelve, whose names are taken from the classes or orders of
Sauvages or Cullen, with the exception of one, suppressorii.
which is borrowed from Linneus.

Here again, therefore, we have a great and noble aim-
whatever be the success of its accomplishment. But as a na-
tural system, even in botany, is to the i)resent hour, and perhaps
always will be, a theoretical rather than a practical idea, there
seems very little expectation that it can ever be realized in me-
dicine. Linneus, indeed, as we learn from his pupil Giseke,
pretended in his lectures on botany, that nature had at length
let him into the secret upon this subject; "I know," said he,
'•' their orders, and their connections, but these 1 will not ex-
plain: — 1 will never explain them." He kept his word too
faithfully; and the fragments of the natural orders which he
left on his decease have been very ineflcclual in completing the
system. It is true that the outlines of the system are before
lis; for he named and arranged his orders; and in many cases
we can follow up and explain the catenation; as for instance,
in passing from the papilionaceoi to the lomrulacecv, from the
dumosas to the sepiarix ; but in many of the links the most ex-
pert botanists are very much at a loss, aiul there are others
that seem to baflUe all inquiry. What, for example, is the na-
ture of the connexion between \\\c palrmv. and the ;7/pr//«!, with
which the arrangement opens? or by what tie is the siliqnosa'
united to any of the orders ?

On the part,*? there fore, of Dr. Parr, the attempt was a bold
one. and his arJ'aAgemcnt will show that, if he have not been

PRELIMINARY DISSERTATION. XXXI

altj02;efher successful, he has exhibited a very considerable de-
gree of ingenuity. This arrangement is as follows:

I. Pyrexia. YM' Adynamije.

II. Phlegmasia. VIII. Paranoia.

. IIL Eruptiones. . IX. Cachexia.

IV. Profluvia. ^ ';' X. Jntumescentia.

V Sui'PREssoRii. , • XI. Ectopia.

VI. Spasmi. , ■ Xli. Plaga.

Between most of these we can trace, in the series of their
descent, a verbal connexion ; and between several of them a
connexion of a more substantial kind. It holds nominally
in the first three orders, but seems to slip from us in the three
that follow ; and is occasionally recovered in the remaining.
Yet when we examine the genera and species of the respec-
tive orders, we shall (ind the connexion is too commonly noth-
ing more than verbal. Phlegmasia has a manifest relation to
Pyrexia ; but in coeliaca, leucorrhcea, leucorrhois, (discharge
of white mucus from the anus) which are diseases of the former
order, the connexion is entirely lost: nor will it, perhaps, meet
with general approbation that these, together with gonorrhoea,
(used in the vulgar sense of the term) cystirrhoea, and phthisis,
should be united with coryza and dysentery, under one com-
mon genus, to which is given the name of catarrhus. This,
however, is a genus upon which Dr. Parr peculiarly prided
himself, and upon which he unquestionably bestowed very
great pains. In like manner (he order eruptiones seems at
first to claim a near affinity with Phlegmasia ; and in the genus
exanthema it does so substanti;dly, for here we can trace dis-
tinc'ly something of thnt febrile, or to speak more correctly,
pyrectic diathesis, which unites these two orders with the or-
der PYREXIA. But in the mere cutaneous eruptions, here col-
lected info one genus, named efflorfscmila^ the line of union
becomes so fine and filmy as to be altogether invisible. Were we
to pursue this prying indagation, we should soon arrive at breaks
far wider and more obvious. It would perhaps be didicult to
find four diseases more discrepant from each other than dys-
pepsia, amentia, amaurosis, and agenesia. They seem to have
no one common property with each other. Dr. Parr, how-
ever, has contrived to make them all species of a single genus, to
which he has given the name oi anepilhymia, and v/hich he has
defined, " a diminution of power in the different functions :" —
a character sufficiently sweeping to cover at least, half the dis-
eases that man inherits; for excess- and dimimtlion of power
may easily be made to embrace iheyfhple ^.M are made to

XXXI 1 PRELIMINARY DIS&IERTATION.

do SO under the Brunonian thebrj. Yet, notwithstanding this
licentious generalization, and aim at a natural arrangement,
the diseases of the externat senses Which seem to have a pret-
ty close proximity with each other, are partly scattered at
considerable distances over the entire sj^sterijif and partly, as in
the instances of caligo, dysopia, paracusis, anosmia, :|ageustia,
anaesthesia, are in the unfortunate situation of Dr. CuHen's
" Catalogus morborum a nobis omi$sorum :" — and, from forget-
fulness or some other cause, have- no place allotted them in
any section of the system.

There is, nevertheless, much- in Dr. Parr's system that is
highly meritorious ; — the distinctions of the different divisions
are scientifically laid down ; and, except that the genera are
occasionally too extensive, accurately maintained. He has
certainly generalised too freely : but his example is good upon
the whole, well worthy of study, and, in various cases, of imi-
-tation. Many of his specimens are drawn with great nicety;
and it is no small praise that his theory is kept in due subjec-
tion, and is seldom more than a handmaid to his practice.

XV. Some years after the writer had laid down the outlines
of the ensuing method, he had the gratification of reading Dr.
Young's Introduction to Medical Literature, including a System
of Practical Nosology. This work', though limited to a single
octavo, embraces a much wider field than is proposed in the
present attempt ; for it ranges through an entire course of me-
dical education, anatomical, pathological, therapeutical, and
chemical, as well as nosological : whilst in the last department
it is drawn up with a somewhat different view, and is more
strictly limited to the pale of the medical profession. So far,
however, as it touches upon the plan now submitted, the author
has beheld, with great pleasure, his own ideas of what ought
to form the basis of a nosological system corroborated by those
of a writer, to whom the literature of this country and of Eiu'ope
is under no small obligations. Tlie arrangement of Dr. Young,
while essentially distinct from the present, will be found per-
haps to make the nearest approach to it of any that have
hitherto appeared. In wanting the division of orders to two
of its classes, it is scientifically defective ; but its systematic
boundaries are as clearly seen, and as precisely maintained,
as those of Dr^. Parr. Yet its chief merit, perhaps, consists in
offering' to the student a masterly guidance, through the whole
of his profossional tuition, to the best authorities and sources
of inf<)»*m'''ipo ; \n this respect answering the purpose of Plou-
cjiict's seven ^arlo volumes, .with a great saving of expense.

PRELIMINARY DISSERTATION. XXXIU

i , - '

a'- prodigious saving of time, and by a far nearer and pleasanter
pathway. J '

XVI. A glance has already been given at a few limited no-
sological arrang«raients, by writers who have confined their at-
tention to a sin^e family or group of diseases, detached for
this purpose from thei-rest; and to this description of works
the author has applied the name of monograms, imported from
the region of natural history. To the names of Selle, Pinel,
and Crichton, it is necessary tp add, under this view of the
subject, those of Plenck, Willan, Abernethy, and Bateman, to
all of whom the present volume is in a greater or less degree
indebted. '

Dr. Plenck, of Baden, is the author of two distinct treatises
of this kind; the one a methodical arrangement of the "Dis-
eases of the Eyes;"* and the other of " Cutaneous Diseases."!
In the former he follows the order of anatomy in the distribu-
tion of his primary divisions, beginning with the eye-brows, and
descending from without inwards till he closes with the retina.
In the latter, which consists of classes, genera, and species,
without the interposition of orders, he employs a looser line of
succession, though the general idea seems to be that of advanc-
ing from the slighter to the more prominent elevations of the
skin, commencing with macule, and proceeding to excrescen-
tije; the remaining classes consisting of cutaneous ulcers,
WOUNDS and insects, diseases of the nails and of the hair.
He is a more industrious than discriminative writer, as the
reader will perhaps readily concede, when informed that he
has arranged, defined, and followed, through their progress and
mode of treatment, a hundred and nineteen genera, comprising
very nearly six hundred species, or distinct diseases of the eyes,
the genus amaurosis alone extending to twenty species ; and
one hundred and fifteen genera, including nearly as many
species, or distinct diseases of the skin, as belong to the eyes !

Hei mihi ! tot mortes homini quot membra ; malisque
Tot sumus infecti, mors ut medicina putetur !

Yet compression, and a more scientific arrangement, would
make either of Dr. Plenck's attempts a valuable work ; and
Dr. Willan has the merit of having performed this friendly
office to the latter of the two, in his book on Cutaneous Dis-

* Doctrina de morbis Oculorum. Edit. 2nda. Vienn. 1783.

t Doctrina de morbis Cutaneis, qua hi morbi in suas classes^ genera, et species
rediguntur. Edit. 2nda aucta. Vienn. 1783.

XXXIV PRELIMINARY DISSERTATION.

eases; and at the same fflfte of having added so much valua-
ble matter of his own, sfS to entitle it to the claim of being
strictly an original performance. The distinctive characters
of papula, pustule, vesicle, bleb (bulla Germ, blasen), scale, and
crust, are well given and maintained by the former ; but the
latter has expressed them more neatly, and has added many
distinctions which the former does not afford ; whilst he has
drawn his literary and practical history, and treatment of the
diseases discussed, from very different sources; arvfl as far as
might be, from his own personal observations. That Dr. Willan
did not live to finish this valuable work niust be regretted by
every one who has the welfare of medicine at heart ; but the
able and judicious manner in which, it has been brought to a
close by Dr. Bateman has served in no small degree to abate
the general disappointment. To the arrangement of Dr. Willan
the present writer will be found to have paid aS much defe-
rence as the very different nature of a general and a limited
system of nosology would allow; for it must be clear to every
one that had Dr. Willan himself, after having completed the
direct object of his pursuit, extended his views to a systematic
scheme wide enough to embrace the whole circle of diseases,
he must have greatly modified his first and more restricted
system before he could inweave it into the larger plan. As it
is, indeed, it stands in need of no small degree of modification
to clothe it with all the perfection it deserves; for several of
his orders would make better genera; almost all his genera
are decided species, while his species are seldom more than
varieties, and are in many cases so denominated by himself.
In this respect he might have taken a good lesson from Dr.
Young, Dr. Parr, or Dr. Macbride; as he might also from the
two former in giving the essential character of each disease an-
tecedently to the admirable description with which it is follow-
ed up.

The name of Mr. Abernethv is here mentioned in reference
to his methodical '■'• Classification of Tumours.^'' This classifica-
tion is strictly symptomatic, the characters being derived, as
they ought ever to be, as much as possible, from sensible phae-
nomena. The present writer has with liltle difficulty been able
to enlist this elegant attempt into his service; and only laments
that he has not had an opportunity of laying himself under
inore extensive obligations to the same quarter.

PRELIMINARY DIS^RTATION. XXXY

SECTION iR

MEDICAL NOMENCLATURE.'^

I. The perfection of a science clcpends, in no inconsiderable
degree, upon the perfection of its language; and the perfection
of every langua-ge upon its simplicity and precision. A writer
may have-<ilear icteaS in hiniself, but to communicate them to
his reader, his terms must be equally clear, and possess a defi-
nite meaning. The philosophy of the Diiddle ages was a chaos
of darkness and perplexity; and might have descended with
these qualities to the present day, had not Lord Bacon, the
grand luminary of the sixteenth century, given life and uti-
lity to the senseless mass, by calling men from the j:^rgon of
words to the study of things ; and had not Locke and Condillac,
in the ensuing century, set the admirable example of prefixing
a determinate meaning to a host of equivocal words in common
use, and scrupulously employed them in such single significa-
tion. " Vocabula et nomina," says Sauvages, with admirable
force and perspicuity, "sunt signa idearum nostrarum, et tan-
tum valent, quantum sonant, vel quantum, ex definitione con-
stanti, certa est et fixa eorum significatio. Si itaque ob in-
constantiam loquendi eodem nomine plures ideae enuncientur,
CO prolato, auditor quidquid significet hoc nomen non intelligit:
ideoque qui verbis a^,quivocis utitur, is ideo loqui videtur ut in-
telliei non possit. Eodem itaque nomine, unica tantum idea
significari debet, si cordate loquamur."t

In our own times every one feels the advantage which che-
mistry has derived from the universal adoption of the Lavoi-
sierian nomenclature; and though recent discoveries have
clashed with the etymological meaning of several of its terms,

* A considerable part of this section is drawn up from an article upon the same
subject by the author, published in Vol. I. Part I. of the "Transactions of the
Medical Society of London," which was honoured by an award of the Fothergil-
lian medal.

■!• Nosol. Method, Prolegom. p. 26. Several of the sections in M. Cabanis' Re-
volutions et Reforme de la Medicine are well worthy of perusal upon this subject;
and especially sect. viii. of chap. iii. entitled, Grande influence des Langues sur
les Sciences, in which, among other things, he observes as follows : " Ce sont I'ex-
actitude et le bon emploi des mots, ou plus generalement des signes, qu'il faut con-
siderer comme le criterixim de la verite ; c''est a leur caractere vague, a la maniere
incertaine et confuse dont ou les emploie, qu'il faut attribuer les notions impar-
faitps, les prejuges, les erreurs, et toutes les habitudes vicieuses de Tesprit."

" Dans presque toutes les parties de la medicine, la langue est mal faite. Elle
s'est alteree de plus en plus, par la fausse npplication des mots empruntes aux au-
tres sciences, et par un certain jargon, insignificant et ridiculeVque le coupable re-
spect des prejuges populaires a trop souvent fait adopter ayx prAticiens."

XXXVl PRELIMINARY DISSERTATION.

the beautiful simplicity of fts IfJrinciple has proved, and will
long continue to prove, a preserving salt; "and its vocabulary,
instead of being hereby abolished, has been since very largely
enriched and extended. Botany and natural history have also
their respective nomenclatures, to which they are mainly in-
debted for the improvements they have evinced within the last
half century ; and as the nomenclature of the first has been
more attended to than that of the second, the science itself has
discovered a proportionate fore-leap in its progress towards
perfection. '. ,

What has been done for chemistry, botany, and natural his-
tory, ought long ago to have been done for medicine ; whose
vocabulary is a jumble of terms derived from almost everyr
language, and every system, whether dead or living, founded
upon no common principle, and equally destitute of precision
and simplicity. It consists of Hebrew and Arabic terms ;
Greek and Latin ; French, Italian, Spanish, German, English,
and even Indian, African, and Mexican ; often barbtirously
and illegitimately compounded, doubtful in derivation, caco-
phonous to the ear, and, for want of a determinate signification,
formed, as one would think, rather for the purpose of suppress-
ing ideas than of communicating them. It is not necessary to
detail the cause of this confusion. It has manifestly arisen, in
a very considerable degree, from those political and geogra-
phical changes that have marked the history of medicine in its
different epochs, in conjunction Avith that succession of theories,
which, very nearly from the time of Hippocrates, has been
perpetually unfolding to the world ; almost every one of which,
if characterized by nothing else, has at least taken care to mark
its existence by a new coinage of words.

II. The sources then of the impurity and perplexity of me-
dical language may be contemplated under the following heads.
Firstly, an intermixture of difi^ercnt tongues that have no family
or dialectic union. Secondly, the want of a common principle
to regulate the origin or appropriation of terms. Thirdly, the
introduction of useless synonyms, or the adoption of different
words by different writers to express the same notion. Fourth-
ly, imprecision in the use of the same terms. Fifthly, an un-
necessary coinage of new terms upon a coinage of new sys-
tems.

1. Every one knows that the languages chiefly made use of
in the nomenclature of our most celebrated nosologisls are the
Greek and Latin ; and it would have been well if these tongues
had formed tho.jboundary of their vocabularies ; for unqu? s-

PRELIMINARY DISSERTATION. XXXVII

tiohably they contaid'a mint Wjfflciently large for every pur-
pose. Even here, hojvever, we occasionally meet with words
illegitimately compoundcdv as pellagra,* mentagra, tonsillitis.
Butvvho is there that.can endure, in the midst of a Greek and
Lalin vocabulary, the introduction of such barbarous words as
Grampus,! soda.f and scorbutus,§ from the German ; petechia,
or more correctly pelecchia, and scarlatina, from the Italian ;
modorra, niodorrilla, and patursa, from the Spanish ; frambassia,
from the French; nucha, essera,|| (or rather eshera) albaras,1[
subetb, or subeta.'*'* from Arabia ; bereberi, from India ; mor-
dexia, from China ; bichos, from Brazil; mirachia, galiancon,
nambakassa, from Guiana, perhaps, or Guinea, or the Moun-
tains of the Moon ; for we cannot follow up this Babylonish
dialect through the whole of :its geographical travels into

Words so debas'd and hard, no stone
Is hard enough to touch them on.

These terms, however, form but a small sample of the gib-
berish that at present deforms the nomenclature of medicine.
They are drawn from the branch of Nosology alone, and from
writers who possess, and deservedly so, a high degree of cele-
brity ; — for the examples are purposely confined to the works
of Siuvages, Vogel, Cullen, and Darwin.

Had these terms been altogether arbitrary, and had an arbi-
trary coinage of terms been the principle of medical technolo-
gy, there would, perhaps, have been no great objection to the
generality of them. Many of them are sufficiently euphonous,
and each could, in such case, have excited only a single idea.
Buf as this is not the fact, the classical student can never com-
mit them to memory without disgust at so barbarous an asso-
ciation, nor the unclassical student without having a secret and

* Evidently from the Latin pellis, and the Greek ayfn, as Dr. Parr correctly
traces it in his Dictionary. M. Jansens, however, and otlier continental writers,
spell it pp/agra, and confess themselves at a loss as to the origin of the term.
" Nn'nen pelaorse," says M. J. Griece, "videlur originis," — immediately adding in
a not •, " auctor voris, ejus origo, ac etymologia a3que incerta videntur, an a.7riKac
ut tfua-tTri^Ac ■" De Pelagr. Ludg. Bat. 1788.

t Der krampf ; whence our English cramp.

% Das sod, or sodt. Foam or scum boiling up to the surface. The chemical
term soda is from the same source.

i Der scorbut: der scharbock ; perhaps more properly, die scharf-pockc,

jl See the genus exormia, cl. vi. ord. iii. 3. 3.

IT See the genus lepidosis, cl. vi. ord. iii. 4. 2.

*'* See the genus carus, cl. v. ord. iv. 9, 4.

XXXVm PRELIMINARY DISSERTATION.

commendable thirst to be^gjne acquainted with their radical
meaning, which he can OflMc thoroughly accomplish by sacri-
ficinir hi.-; tiaie to a know^pge of the different languages from
which ihey are severally deduced.

2. Yet there is a more serious evil in the want of a common
principle upon which the techniral terms of medicine have
been founded, than in the want of a common language. And
it is curious, and in some degree amu-^ing, to trace the multi-
plicity of accidents or fancies to which we are indebted for
the greater number of words that enter into the medical voca-
bulary.

Sometimes the nomenclator appears to have been smitten
with the love of colour ; and, in consequence, we have black,*
white, green, red, scarlet, yellow, and purple diseases, under
the names of melaena, melas, atrabilis, leuce, alphos, albugo,
chlorosis, rosa, rubedo, rubeola, scarlatina, icteritia, aurigo,
and purpura.

Occasionally the order of time seems to have been the favour-
ite principle of designation ; and hence the distinction of dis-
eases into chronic and acute ; into those of infancy, manhood,
or womanhood and old age; into ephemeral and quotidian ; con-
tinent and intermittent ; tertian and quartan ; or in the more tech-
nical terms of the nosologists, into amphemerine, tritaeophyte,
and tetrartophyte fevers ; into monthly fluxes, spring rashes, and
summer heats. It is upon different modifications of this prin-
ple, as has been already observed, that the arrangements of
Aretaeus, Caelius Aurelianus, and Macbride, are chiefly
founded.

In various cases Natural History or botany seems to have sup-
plied a basis ; and the nomenclator has wandered equally
among birds, beasts, fishes, insects, and plants, for peculiarities
and derivative names. From this quarter we derive the terms
fames canina, rabies canina, (dog-hunger, dog-madness) ; cy-
nanclie (dog-choak) ;* boulimia (ox-maw); pica (magpie-long-

* Cynanche (MJvetyxi{) appears to have been at first a mere verbal mistake for
synanche (^<rwttyy») ; thoii2;ti afterwards employed to denote a particular species of
the synanche genus. It is thus adverted to by Celsus, lib. iv. cap. iv. "Nostri
anginam vocant ; apud Grtecos nomen, prout species est. Interdum, enim, neque
rubor, neque tumor ullus apparet ; sed corpus aridum est, vix spiritus trahitur,
membra solvuntur; id o-uw^X"" vocant. Interdum lingua faucesque cum ru;^
bore intumescunt, vox nihil si^^nificat, oruli vertuntur, faries pallet, singultusque
f;st ; id Miv^yyn vocatur. Ula communia sunt ; aoger non cibum devorare, nou
potioncm, potest; spiritus ejus intcrcluditur. Lcvius est, ubi tumor tantummodo
et rubor est, cetera non sequuntur ; id ita^icwityxn-^ appellant," Several of the
MSS. and codices for " id Mimyx^!' g've " uti awa.yx^'^"'^^'^^'^^ " ^ irwo-yx^- ^he
^'ariorum edition is heie employed, and the following passage from Galen suffi

PRELIMINARY DISSERTATION. XXXIX

in^) ; hippus and hippopjon (hors^winkle and horse-blotch) ;
scrofula (swine-evil); elephr»ntiaai^|glephant-skin); ichLh3'osis
(fish-skin); vitiligo (^nlf-skin) ; ca&^r and cancer-lupus (crab-
ulcer and wolf-ulcer); tantarisniii? (larantula-dance) ; vampi-
rismus (hu-bewitchment) ; roseola (rosWash) ; urticaria (net-
tle-rash); lichen (liverwort-rash).

Sometimes the names of persons or of places have been re-
sorted to as a foundation for distinguishing diseases ; and from
this source ^e have morbus Herculeus ; facies Hippocratica ;
lepra Arabum and lepra Graecorum ; plica Polonica ; sudor
Anglicus ; morbus Gallicus, Hun<raricus, Garhamensium, &c.
To which may be added the names of various saints and pre-
ternatural agents, some of whom have but few pretensions to
the calendar, as ignis Sancti Antonii, chorea Sancti Viti, malum
Sancti Joannis, lues Deifica, Daemonomania. In anatomy the
absurdity produced by this cause exists to a still greater extent,
and has incited several attempts at a reformation, both in our
own country and on the continent, though hitherto without
much success. In our own country the plan proposed by Dr.
Barclay is well entitled to attention ; and in France the exer-
tions of M. M. Dumas, Chaussier, and especially of the indefa-
tigable Vicq. d'Azyr, are too well known to render a glance
at them necessary, were it even consistent with the scope of
this dissertation. In the brain alone we meet with an assem-
blage of terms so ridiculously diversified in their sources and
primary meanings, as frequently to disturb the gravity of the
sedatest face on running them over; and at the same time so
indelicate in many of their references, as to render it impossi-
ble to read them except in a dead language.

The objection, however, in the present instance, does not so
much lie against any one or against all these various sources
of nomenclature, as against the random and indefinite manner
in which each of them is drag ed forward to furnish an occa-
sional supply, and the dull and miserable taste that so largely
broods over the whole.

ciently justifies it, torn. vi. p. 324. " Sive synanchen dicere volueris, sive cynan-
che<n, vel alteruin quidem horum synancliem, alterum vero cynaiichem, sive
utrumque synanchem vocaveris, Huas synanches sciveris esse rationes.' Both
writers evidently lean in favour of 53/nanc/ie ; and l)oth point out the confusion
resulting from the introduction of cynanche along with it. Aetius attenpterl to
support the last by observing, that the patient thrusts out his tongue like a dog ;
and Aretaeus says, that the name was hence derived ; but Caelius Aurelianus and
Paulus used synanche as recommended by Galen, It is curious to observe, that
the proper term is now generally banished, and almost forgotten, while the corrupt
tevmiias usurped its place, .-• ;

y^

Xl PRELIMINARY DISSERTATION.

3. Yet the vocabulary of medicine is. ^ot only not founded
upon any common basis, but perplexed, by the introduction of
synonyms or equivalent terms derived frpm ditferent langua-
ges, in consequence of an almost total want of agreement upon
this subject between the best and most approved writers. A
few examples will best explain the author's meaning.

The more common terms among the Greek, physicians for a
morbid excess of appetite, are boulimiasis, cynorexia, and ly-
corexis ; among the Latins, who have merely translated these
terms, fames bovina, canina, lupina. Avicenna uses bolismos,
and many writers bulimia ; while others, dissatisfied with the
gross idea conveyed by all terms of this kind, have racked
their genius for substitutes, and have at least doubled the num-
ber. Hence Plutarch tells us that the technical term in his
day was palulimos ; while Caelius Aurelianus employed phage-
daena, several addephagia, and a few esurigo. The Arabian
writers employed nehem, and sometimes jerkua.

In like manner depraved appetite is indiscriminately denomi-
nated citta, cissa, allotriophagia, by the Greeks; and pica and
malacia by the Latins ; though this last term is also of Greek
derivation.

Variola and varicella, though descending to us from the
Latin, through a Spanish medium, are unobjectionable names
for small-pox and chicken-pox.* But as the second disease

* Sauvages, indeed, does not use varicella, and objects to variola ; " variola et
patursa," says he, " ut barbara ableganda." Prolegom, p. 30. But this would be
to make sad havoc with nosological terms, many of which, as rubeola, rosalia,
urticaria, though of Latin origin, have reached us through the medium of the
Spanish or Italian schools, and hence with a diminutive termination, not, indeed,
authoritatively Latin, but allowably so, and sufficiently euphonous to please the
nicest ear. Variola and varicella are both derived from the Latin varus, '* a pock
or pimple," which has furnished the Castilian dialect with vario and variz, and
hence the diminutives variola (now altered by a change of accent to variola) and
varizella, now uniformly written varicella. The Arabic term for the small-pox is
nebekk, the radical meaning of which is, " protrusion, elevation, acumination ;"
and which corresponds, therefore, with the Latin varus, and probably gave rise to
the Spanish variola as its literal rendering.

It is generally said that the Arabic name for the small-pox is chaspe : but this is
a mistake. Chaspe is used by Rhazes and other Arabian writers to indiratp this
disease, but the term itself jsSyriac, and like the same term in Chaldea, }^2D3)
means directly erM6e.scence ; the flush of red so readily diffused over tho ciiceks
of the bashful and modest; and indeed the Chaldee root impn'^'n its primary
sense (C|D3 pudore suffundi; whence in the conjugation aplu I C^DD^^ nidefactre,
/mdore suffundere, confundtre. In Hebrew the same term isenipi , nd to em-

iiurt tlie same effect, but by a different mean, for in this last tongcc tlp3 ignifies
'•to turn pale or wan," from shame; and is rather, therefore, ignomintd affi.ci,
than pudore ajffici. \

Among the Arabian writers we meet with a variety of Syriac terms ; for though
.\vabic was the fashionable and court language of all the caliphats, Syriac was

PRELIMINARY DISSERTATION. xli

was formerly conceived to' be^tiothing more than a species or
variety of tiie first, Ihe student has still to follow chicken-pox
through many nosologies, and perhaps all the medical lexicons,
under the name of variola lymphalica, as well as under that of
varicella. In like manner rubeola, the more common term for
measles, and like the preceding a Spanish diminutive from a
Latin root, is denominated by Sydenham and Morton, morbilli ;
by Sagar, fcbris morbillosa; by the translators of Avicenna,
variola cholerica ; by Castelkis, roseola. So heart-burn is
sometimes styled cardialgia, sometimes pyrosis, from the Greek,
and sometimes soda, from the German. Wakeful, coma, com-
monly denominated coma vigil, is by Linacre called marcor;
by Sauvages typhoraania ; by the Spanish writers modorra.
St. Vitus's dance is chorea, chorea Sancti Viti, and scelotyrbe;
the last a very improper term, though descending to us under
the authority of Galen ; since we know from Pliny that it was
also used among the Greeks to denote a particular species of
scurvy. Thus, again, sleep-walking is denominated noctara-
bulismus, somnambulismus, hypnobasia, and nyctobasis ; night-
mare is called incubus, succubus, ephialtes, prigalium, and epi-
bole; while epilepsy has a still greater choice of names ; and
for syphilis they are almost innumerable.

4. Yet we are not only overloaded with terms to express the
same common idea, but of these terms a very great number are
so loose and indefinite as to convey no precise idea whatever ;
while others, on the contrary, cannot fail to express a very er-
roneous one. Let us take, as an example, some of the names
invented to denote the last of the above diseases. Fracastorio,
whose muse deserves (o have been better employed than in
composing a very excellent and classical poem upon so disgust-
ing a subject, denominates it syphilis, Astruc, lues, both which
names are, as to their origin, unexceptionable. But when,

the country language of Cairo and Bagdad : many of these writers, moreover, were
born not in Arabia, nor within the precincts of the Saracenic court, but in Syria or
Persia; and hence had to study Arabic as a part of their classical education, and
on this account we meet occasionally with Persian as well as Syriac terms. Thus
Mesne was born and brought up in the former country, and Rhazes in the latter.
The works of Mesne were first written in Syriac, and afterwards translated into
Arabic; and it is perhaps from him that Rhazes derived the term. The Persian
name, indeed, for the small-pox is evidently of Syriac and not of the Arabic origin, for
it is founded not upon the nature of the pimples, but upon the inflammatory redness
of the skin which precedes their eruption. This teini is serkhyche liom serhh
*■' ruber, rubedo :" being, like the Syriac cJiaspe, peculiarly applied to the redness
or blush of modesty ; \vher\ce serkh rjti is expressly " erubesccrc, rubore suftuiidi."
The Greek translator of Rhazes follows the same clue ; tot jae renders " chaspe"
iui>Koyi!i, or " incendium,"' as Machelli has given it in Latiii. The common read-
ing, indeed, is tvxoyia., but this is evidently a mistake of the copyist, and has beeu
Jong admitted so by the interpreters, ", •

F

xlil FRELIMINARY DISSERTATION.

after Baglivi, it is called morbus Gallicus, and after the French
writers, who did not choose to accept the compliment, lues
Neapolitana, or lues Bavarica, the disease is, at least, loosely,
perhaps erroneously, characterised. By.'Joubert it is desig-
nated variola magna ; and thus, not to mention the absurdity of
coupling the adjective mifgna with a diminutive substantive, we
have it confounded with another disease, -w^f^h has scarcely a
single symptom in common with it. By cMier writers it is de-
nominated with equal incorrectness, from some individual or ac-
cidental circumstance alone, or some particular part of the body
on which it happens to light with peculiar severity, and hence the
unclassical terms ofment-agra and pudend-agra ; which last, as
though to increase the confusion, is introduced into the nosolo-
gies of Linneus and Sagar to express a local atfection of a very
difterent nature. Upon the same absurd principle the Spanish
writers called it bubos ; the Neapolitans pellarola, orchiarolla.
and unghiarolla, according as the eyes or skin were chiefly af-
fected.

Mania is universally employed to signify a particular species
of madness; but typhomania, instead of madness, means a par-
ticular species of wakefulness, the ety^vir*of xMftx of the Greeks,
and the coma vigil of the Latins ; the subat asarim or interrupt-
ed somnolency of Avicenna.

Melancholia and atrabilis are univocal terms, and both were
formerly used to denote vomiting or dejection of black blood,
or blood intermixed with bile. In later periods, however, the
latter alone has been employed to express this disease, the
fitXetitix. of Hippocrates, while the former has been growing into
general use to express madness confined to a particular sub-
ject.

What can be more difterent in their commencement, or re-
quire a more different mode of treatment, than the two species
of continued fever synocha and synochus? yet a mere arbitra-
ry change of gender, in a common term, is all by which we
have to discriminate them in the best modern nosologies.

Phagedena, in Caslius Aurelianus, and those who have fol-
lowed him, means, as already observed, canine appetite ; in Ga-
len, and most writers of the present day, a gangrenous ulcer.
The wind-pipe among the Greeks is denominated cricos, from
its annular form, and trachoea, from its asperities. The anato-
mists and surgeons, as though not knowing which of the terms
to prefer, have consented to divide them; the former taking the
first, and the laUerthe second. Hence the rings of the larynx
are denoniiiiatccl cricoid cartilages, and all the muscles attach-

PRELIMINARY DISSERTATION. xliil

«d to them are distinguished by words compounded of crico, as
crico-pharjmgeus, crico-thyroideus, &c. The surgeons, on the
contrary, who Hmit themselves to the latter term, instead of
crico-cele and crico-tomy, speak only of tracheocele and
tracheotomy. The "nosologists have made co!;rnmoa cause
with the surgeons':; and hence, instead of cynanche cri-
calis^ we have Cfkfitt^healis, The one is, perhaps, as good a
term as the othei',*'ibut one is sufficient; and if the nosolo-
gists and surgeons make their election of trachea, how imme-
thodical and, to the unlearned, how perplexing, is trach-oma
for a disease of the eye-lids.

Storaachus and stomachicus are terms that apply to the sto-
mach ; stomacace to the disease called scurvey; stonialgia to
a particular affection of the tongue. The radical term in all
these is the same ; and the Greek etymologist, though he may-
disapprove of one or two of the compounds, will have no diffi-
culty in tracing them home. But as every medical student is
not a Greek elymologist, many must be bewildered in their vo-
cabulary, more especially when they find that stomacace is
also employed by several Avriters to express St. Vitus's dance.

What is the meaning of lone ? In physiology, in pathologj',
and in the common language of the multitude, sound and accor-
dant elasticity; that voluntary reaction or state of extension
between antagonist muscles, as Galen has well observed Irom
Hippocrates, by which they are removed from a condition of
rest ; and in which the one yields to the other, not from actu-
al debility, but in a precise ratio to the surplus of power ex-
ercised over it.* Whence that class of medicines which con-
tributes to this harmonious play of muscular fibres in irritable
or weakened organs, is denominated tonics ; while organs that
are destitute of it are said to be in a state of atony. But if
tone be used to imply health, and tonics restoratives of health,
what are we to understand by the phrase Ionic spasm ? — u
phrase founded upon an erroneous pathology, too frequently
leading us astray in our practice, and applied to a state of mus-
cle in which there is no more tone, elasticity, or healthful re-
action, than in the frozen strings of a violin. To show the
utter absurdity of this phrase, it is only necessary to translate
it, and to tell the Ens;lish reader that it is liierallv extensible
contractiliixj,

5. The last source of imperfection and perplexity it is neces-
sary to notice, is the coinage of nev/ terms upon the coin.age of
new systems. This has been a very ample aitd inveterate me-

-'■' — — ■ ■!--• ~

*De Mot. Muscul.l. ii.

Xiiv PRELIMINARY DISSERTATION.

diuni of error ; and one which has not merely run through our
nomenclature, but through Our reasonings; insomuch that,
through its prolific influence, the language of medicine is be-
come a curious mosaic of the chief speculations of ancient and
modern times. The dogmatic, empiric, and methodic theories
still contribute something towards this general effect; the cor-
puscular has added much ; the humoral still more; the. alche-
mical has kept pace with the huoioral ; and .the geometrical
has not stopt far behind. The spasmodic. hypotheses of Hoff-
man and Cullen are by no means unamenable to this remark.
In effect the new and unsatisfactory character of much of its
phraseology formed no inconsiderable source .of the Brunonian
opposition to it, and laid the first foundation of the Brunonian
doctrine. Yet the followers of this last speculation have no
great reason to triumph. The terms introduced by Dr. Brown
arc seldom strictly correct in themselves, to say nothing of the
looseness with which they are employed, both in his own writ-
ings and in those of his warmest advocates ; while, in the more
elegant display of the same opinions in the Zoonomia, the read-
er is dazzled i-ather than enlightened, and furnished with fine
words rather than with accurate notions.

It is almost superfluous to give examples under this general
remark. Crudity and crisis; pores and corpuscles; acute and
chronic ; humour and idiosyncrasy ; digestion, concoction,
and dissolution ; effervescence, fermentation, and putrefaction ;
lentor and error loci; choleric and nervous; phlogistic and
antiphlogistic; tonic and clonic spasm; action and condition;
miasm, contagion, and infection ; sthenic and asthenic ; excite-
ment and excitability ; accumulation and exhaustion ; sensitive
and irritative motions; decreased volitions; direct and reverse
sympathies; nature, non-naturals, vis naturae, vis insita ; forced
state of life; procatarctic, proegumenal, remote and proximate,
continent and incontinent causes: — these terms are sufficient to
convey an idea of the succession of influences here referred to ;
and as they arc all to Ijc found in our lexicons, and other books
of general reference, often, indeed, in conjunction with terms
still more clashing and contradictory, they cannot fail to indi-
cate the discordla concors of the medical language of the day,
the emb'jrrassmcnt of its phraseology, and the difficulties which
the student has to encounlcr from this source alone, in the pro-
gi'css of Iiis professional education.

PRELIMINARY DISSERTATION. xlv

SECTION III.
SCOPE OE THE PRESENT DESIGN.

i. It is obvious then, that the healing art stands in considera-
ble need of improvement in its two important branches of noso-
logical ARRANGEMENT and NOMENCLATURE : and it is, among oth-
er points, to an improvement in these two branches that the
ensuing pages are especially directed.

In giving an outline of what the author proposes in order to
accomplish this purpose, it is of little consequence which of
these two divisions shall first pass in review before us : let us
then begin with that of language or nomenclature, as being,
perhaps, freshest in the memory.

In the hope of giving some degree of improvement to the
medical vocabulary, as far as he may have occasion to employ
it, the author has endeavoured to guide himself by the follow-
ing general rules. Firstly, a strict adherence to Greek and
Latin terms alone. Secondly, a use of as few technical terms
as possible, and consequently a forbearance from all synonyms.
Thirdly, a simplification of terms, as far as it can be done with-
out violence or affectation, both in their radical structure and
composition. Fourthly, an individuality and precision of sense
in their respective use.

I. As the science of medicine is open to all ages and nations,
it would be highly beneficial, if it could be accomplished, that
its technology should be confined to one alone of the many
tongues from which it is at present derived. No modern tongue,
however, would be allov/ed such a precedency ; and were it to be
granted, there is none so richly endowed with distinct names
for diseases as to enable it to specificate every complaint of
W'hich a system of nosology is expected to treat. Dr, Mac-
bride has made a trial of our own tongue, and has completely
failed ; for the generic terms, under several of his orders, are
entirely exotic, and under most of them very considerably ro^
being partly Greek, partly Latin, and partly English, nnconth-
ly mixed together for the sake of convenience, like foreigners
from all countries at a Hamburgh hotel.

Our choice, therefore, is limited to the Greek and Latin,
which have for ages maintained so equal a sway in the pro-
vince of medicine, that they must still be allowed to exercise a
joint control. It is a singular fact, that thcGrccIf has furnished
us with by far the greater number of terms thatVJ.istingnish the

xlvi PRELIMINARY DISSERTATION.

higher divisions of systematic nosology, the classes, orders,
and genera ; and the Latin those employed to indicate the
species and varieties. The systems of Linneus and Darwin
offer, perhaps, the only exception to this remark; for here we
meet with attempts to use the Latin tongue alone, or at least to
give it a considerable preponderancy. These examples, how-
ever, have not been followed, and are not likely to be. The
greater flexibility, indeed, and facility of combination belong-
ing to the Greek, has, on the contrary, induced almost all other
nosologists, as well as almost all other men of science, to turn
to it for assistance far more frequently than to the Latin. The
author has availed himself of this general taste, and by an oc-
casional revival of terms which ought never to have been drop-
ped, has been able so far to simplify the nomenclature of his
classes, orders, and genera, as to render them exclusively
Greek ; and consequently to take his leave, thus far, of all
other languages whatever. The changes introduced for this
purpose are by no means numerous, and will in no instance,
as he trusts, betray affectation or coercion. His authorities
will usually be found in Celsus or Galen, who have so careful-
ly handed down to us the distinctive terms both of the earlier
and the later schools of Greece ; and if at any time he have
had occasion to wander farther, he has usually supplied him-
self from Aetius, CiTclius Aurelianus, Dioscorides, or Aristotle.
The sources, however, from which he has drawn, are in every
case indicated, and, he ventures to hope, will be generally ap-
proved. Concerning the specijic names he has been less scru-
pulous; and has allowed those to stand, whether Greek or
Latin, that are already in most common use ; or has drawn
from either language such as may most fitly express the essen-
tial character, wherever such character can be traced out. Yet
even here he has never wandered from the Greek farther than
into the Latin.

2. The machinery of every art or science becomes simpler,
and its auxiliary powers fewer and less needed, as it advances
towards perfection. It is the same with their technology.
While we are but loosely acquainted with the principles of an
art, we speak of them with circumlocution, and employ more
words than are necessary, because wc have none that will
come immediately to the point. As we grow more expert we
learn to makeia selection ; wc give to many of them a greater
degree of forc0,and precision ; and separate those that are thus
reiidered of rcjal value from the " leather and prunello," the
heavy outside ^ho\^|^jjLuseless and unmeaning terms with which

PRELIMINARY DISSERTATION. xlvii

ihey are associated ; and thus gain in time as well as in power.
In unison with these ideas, the author, as soon as he has pitch-
ed upon a word that will best answer his purpose, will be found,
as he hopes, to adhere to it wherever he has had occasion to
advert to the same idea, without indulging in any play of syno-
nyms, or different terms possessing the same or nearly the
same meaning. Marisca and haemorrhois have been equally
employed by medical writers to distinguish the disease which
we call vernacularly pt7es. The first is a Latin term, and re-
fers to the tubercles of the disease, and the second a Greek,
and refers to a discharge of blood which occasionally issues
from them. As commonly used, they are direct synonyms, not-
withstanding this difference of radical meaning, and either might
answer the purpose; the diversity of the disease being pointed
out by distinctive adjuncts, as caeca, mucosa, or cruenta. Sau-
vages and Sagar, however, have employed both ; but have
laboured to establish a difference, without having succeeded
even in their own judgment. So that in these writers, we have
one and the same disease described under two distinct genera
in distinct classes; the first occurring in Sauvages under class
I. ord. V. entitled, vitia, cystides: the other under class iv.
ord. ii. entitled, fluxus, alvifluxus, and introduced with this
remark, " h^morrhoides vero nihil aliud sunt quam marisca,
gazae apud Aristotelem." In the present .system, marisca* is
alone retained ; and the author has preferred it to haemorrhois,
first, because hemorrhage is only a symptom that characterizes
a peculiar species, or rather, perhaps, a variety of the disease ;
and next, because hasmorrhois, or rather haemorrhoidae, («/^-
iffoJ'a.t) was employed among the Greeks, as well vulgarly as
professionally, in a much wider sense than that of modern times,
and imported flux of blood from the vagina, as well as from the
anus ; and, in fact, from any part of the body, when produced
by congestion and consequent dilatation of the mouths of the
bleeding vessels, which were supposed in every instance to be
veins. So Celsus, "Tertium vitium est, ora venarum tanquam
capitulis quibusdum surgentia quae saBpe sanguinem fundunt:
«»(MOfp««Jkc, Graeci vocant. Idque etiam in ore vulvse fasminarum

* The teim occurs in Juvenal, in its medical import, ii. 12.

podice lev!
Caiduntur tumidae, medico ridente, MARlscjE.
In Martial it occurs frequently in the literal sense of fici, "flethy or succulent
figs or raisins." The spongy and succulent bulrush of the marshes, or grounds
overflowed by the sea, was called mariscus, from its habitation .a mart: and hence,
probably, the name of the spongy and succulent tu^i^BjRS which constitute the
piles. Our English marsh has the same origin as 7?iar|w>K'

Xlviii PRtLIMlNARY DISSERTATION.

incidere consuevit." To the same effect Hippocrates, Lib. de
Morb. Midier. Galen uses it in a still wider extent, De Morbis
Vulgaribus ;* and hence the woman with an issue of blood in St.
Matthew, ch. ix. 20, is termed in the Greek text >w« a<^cppoK3rrt.t
Gaza (^«fct), the term used by Aristotle, would have answered
as well as marisca, but that it is less common in the present
day, and an exotic term even in the Greek. Hesychius calls
it a Persian word, and Scaliger coincides with him ; translating
it "thesaurus, reditus, tributus," "a treasury,'''' or place of de-
posit or accumulation, chiefly of tribute or taxes. It is rather
an Arabic than a Persian term, though both countries use it
under different inflexions. The Arabic root is (khazi) " a blush
or ruddy flush," whether from fulness, shame, or modesty;
whence the verb (khaza) " to produce blushes, erubescence, or
suffusion ;" and hence (khazan) in Persian, signifies " autumn,
or the season of fulness and erubescence ;" while (khazain) in
Arabic is " a garner, treasury, or repository for the fulness of
the autumnal months;" literally cella, celhila, gaza, or gazophy-
lacia, as explained by Hesychius.

Vogel and Plenck are overloaded with synonymous terms,
or what may, for common purposes, be so regarded ; and, per-
petually aiming, like Sauvages, in the preceding instance, to
discover a distinction where none exists, they have multiplied
their list of disease ^ as we have already seen, almost without
number. The discrimination of Cullen has here been employ-
ed to the highest advantage, and is entitled to the thanks of
every one. Celsus is in this respect peculiarly correct ; he
adheres to the best technical term supplied by his own tongue ;
and though he cai-efully gives us its Greek synonym, he never
changes it for any other term, whether Greek or Latin.

3. In improving the technology of an art or science, it seems
of great importance not only that all unnecessary terras should
be banished, but that those retained should be simplified and
abbreviated as much as may be without injuring their force or
precision. Nothing can be more repulsive to the eye of a
learner, or more inconvenient to the memory of an adept, than
the long cacophonous compounds with which the science of no-
sology has been loaded l)y several German writers ; such as

* Comin. VI. cap. xxv.

t Sauvaines, not sufficiently attending to this extensive sense of the tenn anion;;
ilie Greek wiiteis, represents this disease in St. Matthew as a marisca cruenla, or
case of Ijleeding piles, instead of a catanienial hBcniorrluige. " Hrcmorrliois, a
(Jricee aima ct rhrOy est lluxus sanguinis Kx mariscis ; undo inulier in pAanijelio
hnmorrlwissa dicta fuit." Vol. i. p. 1(J4. .^jmd Mtirixram.

PRELIMINARY DISSERTATION. xllX

the pothopatridalgia of Zwinger, for which, lo the consolation
of every one's lips and ears, Nenter auspiciously invented nos-
talgia; the ancyloblepharon^ hydrenterocele^ and others already
noticed of Vogel, for which it is scarcely worth while to look
for better to supply their place, as they import mere shadows
of real diseases; and such specific epithets as spondylcxarthretl-
cus and hydrocatarrhophicus, employed in the nosology of Plou-
quet, but far more likely to produce than to remove confusion.
To this point the author has endeavoured to keep his eye stea-
dily dii'ected ; he has avoided compound terms as much as
possible; and when compelled to have recourse to them, has
aimed at restraining them within compass.

Much of the character of words in respect to dimensions
and euphony,, as well as to precision, depends upon the com-
mon prefixes and sulfixes which it is occasionally found ne-
cessary to employ ; and which in some branches of science,
and especially in that of chemistry, create and regulate con-
siderably more than half their nomenclature.

This subject opens a wide field, though the consideration
of it, for the present, must be confined to a very narrow
compass. It is altogether new, not only to medicine, but, as
far as the author is acquainted, to Greek philology ; at least,
after an extensive inquiry, he has not b^f^n able to obtain any
assistance from books'professedly devote to it. There seems
much reason to believe that the auxiliary parts of every com-
pound term, not only in medical technology, but through the
whole range of the Greek tongue, had, when first employed,
distinct and definite meanings, and limited the radicals, with
which they were associated, to peculiar modifications of a
common idea. To these meanings we can still trace many of
them, though the greater number, like most of the elements
in the Chinese characters, have passed through so many
changes, that it is difficult, and in some instances perhaps impos-
sible, to follow up the analysis to their original sources. From
the novelty of the subject the author has, perhaps, a fair
claim upon the reader's indulgence ; the inquiry, however, is
worthy of being carried much farther than he has time or lim-
its to pursue it ; and he hopes, and has reason to believe,
that it will be thus extended, before long, by a friend, who
has far more competency for the purpose than he can pretend
to.

The suffixes employed in medical technology are more nu-
merous than the prefixes, and the following is a list of those
in most common use :

PRELIMINARY DISSERTATION.

Greek ^

Latin

i

I

Agi-a

algia

asnia

asmus
esmus
ismus
osma

cele

copus

esis

iasis

itis

odes

odynia

osis

rhagia

rhoea

igo

ula

ilia

ularis

illaris

osus

etxync

tfts

irii

ttSus
cfuvlet
emu
fdytit

fUM

The common prefixes are uniformly Greek, and are as follow

A

ap, ap'

aph'
caco, cac'
cata, cat'
dia
dys
cc, ex
en
epi, ep'

eph'
liyper
hypo

para, par'

peri

syn, sym, sy'

xa«0, KetK
XATct, KCtT*

iV
iTTt, eT

VTttf
V7T0

Trap*, 'Tctf

TTlft

ffim, avf*) ffu'.

These auxiliaries are far too numerous, and, in the course
of the vocabulary, recur far too frequently. Some of them
however may be suppressed, as synonyms or duplicates of
others ; while it should be a rule never to employ any one of
the remainder but when absolutely necessary to distinguish
the compound into which it enters from the root itself, or from
another compound derived from the same root, by the addi-
tion of an idea to which it is uniformly restricted.

Algia, copus, and odyne, are direct synonyms ; to which may
also be added agra, for though of a somewhat different radi-
cal meaning, it is cQmraonly superadded, like all the three

PRELIMINARY DISSERTATION.

li

former, to express the general idea of pain or ache. And
hence, very much to the perplexity of the learner and the in-
cumbrance of the technical vocabulary, we have cephal-algia
for head-ache, gastr-odyne for belly-ache, chir-agra, and pod-
agra for gout-ache in the hand or foot. And, worse than this,
we have ost-algia, ost-odynia, ost-agra, and osto-copus, to sig-
nify one and the same affection of the bones. Now it may be
necessary to retain algia, which is perhaps the most popular of
the whole, but we should as far as possible banish all the rest;
and with the exception of agra in the single instance of pod-
agra, which cannot readily be dismissed, none of the others
will be met with in the course of the ensuing arrangement.
Parodynia will indeed be found, but in this case odynia is the
root itself.

Esis, osis, itis, oma^ and iasis^ have been employed perhaps
for ages, and several of them very generally throughout the
Greek tongue, as mere terminations, without any direct refer-
ence to their origins : and probably without a recollection or
belief that they have any significant origins, or that those ori-
gins can be traced : in which case they would become simple
terminating synonyms, and, in the abbreviating aim of a tech-
nical nomenclature, ought to follow the fate of the generality
of the preceding list. Some of them, indeed, can well be
spared; but accident, or a cause not eas} to be explained, has
given a peculiar and useful meaning to others, though very
different from their radical sense, and these may be advan-
tageously retained. The first three are probably, derived
from tm or its different compounds, and together with the Lat-
in term igo, which is perhaps a corruption of ago, imply the
common idea of " ago, mitto," " motion, action, or putting
forth," and consequently, in medical combination, of " morbid
motion or action." Esis (ow) is a direct derivative from «*> as
is obvious in paresis, literally " submissio," "remissio," " lax-
atio," " restraint or inability" of " moving or putting forth ;"
whence by Aretaeus, and various other Greek writers, it is
used synonymously with paralysis. We meet with the same
word and the same radical idea in proesis synesis, and other
compounds of the same root. Osis (mm or oua-n) descends in
like manner from ei/ui, " sum" itself a derivative of ««; whence
osia or ausia (»«« or ouo-ia) is literally " ens, essentia, substan-
tia," the thing put forth " in being, action, or moti6rt."'/<Js .(/«;)
is as clearly an immediate derivation from nf^M; itself, like the
preceding, a ramification from «», and imports, not merely action,
but when strictly true to itself, " impetuous or violent action^"

iii PRELIMU^ARY DISSERTATION.

The literal rendering of «f^«« is " feror impeiu," and that of irnc is,
•' temerarius, audax, praeceps periculorum." While the direct
origin of igo betrays itself in all its compounds, for vertigo (de-
riving igo from ago) is literally "rotatory motion or dizzi-
ness;" serpigo, "serpentine motion or course," peculiarly de-
scribing a particular modification of herpetic eruption to which
the term serpigo is applied. /

lasis, and oma, convey different ideas as issuing from diffe-
rent radicals. lasis (w«f) is literally sana/io, from ''m/xm, " sano,
medeor," and hence necessarily imports, in composition, " me-
dendus," or " ad sanationem spectans." Oma (**»«) is as ob-
viously an inflection of a>fAo;, " crudus, ferus, imperfectus," as is
its real meaning in sarc-oma, distinctly " crude, wild, imper-
fect flesh :" ather-oma, " crude, incocted pulp or pap." But if
oma be preceded by the letters pt, as in ptoma (^--ra;/**) it is then
derived from 5T«?rT«, " procido," and constantly imports /)roa-
dence or prolapse ; as in pro-ptom-a, " a prolapse of any part ;'*
archo-ptoma, " a prolapse of the anus." This is sometimes
written ptosis, as in colpo-ptosis, " a prolapse of the vagina ;*^
hystero-ptosis, " a prolapse of the uterus :" but for the sake of
perspicuity, and especially to the learner, one mode only ought
to be adhered to, and perhaps the first is the best.

Asma (flfo-jtta) is strictly " incantamentum," enchantment, incan-
tation ; and, in a looser sense, possession, seizure. Osma, asmus,
esmus, and ismus, are mere varieties of asma ; and that they
were at first intended to denote this idea we may judge from
the terms phantasma, enthusiasmus, phricasmus, marasmus,
phrenismus, priapismus. It became long afterwards a terminal
member of tenesmus, rheumatismus, ptyalismus, when the orig-
inal sense was nearly or altogether lost sight of. And since
this period the entire group have been employed not only so
generally, but in such a multiplicity of senses, that we can nei-
ther banish them nor define them ; whence, like esis and osiff,
they must remain to be had recourse to as mere final adjuncts
whenever necessary, though the less frequently employed the
better.

It is clear, then, as well from actual analysis, as from the ge-
nius of the Greek tongue itself, that each of these terminations
had a distinct signification when first introduced ; although it
is equally clear that most of them have for some centuries been
employed loosely and indiscriminately as mere final syllables.
In many instances none of them are wanted ; and in all such
cases they ought, unquestionably, to be dropped as redundant ;
pn^, occasionally, they have beeq so. Thus the myopiasis of

PRELIMINARY DISSERTATION. Hi

Hi

Vogel is advantageously shortened by Plenrk to myopia^ as at
first written by Linneus ; and, for the same reason, mydriasis
ought to have been written mydria. So chlorosis, if it were to
be formed in the present day, w^ould be chloria, and exoneirosis,
exoneiria. Many of the terms introduced by Dr. Young seem
to be formed directly upon this b^^is, and are highly entitled to
attention ; as phiysis, palmus, pne^is.

In various instances, again, we find, as already hinted at, sev-
eral of the terminations, apparently from some accidental cause,
taking a peculiar bearing which it would be right to encourage,
as long as they are retained, so' as to give them a direct and
definite sense. Such especially is the case with itis, which,
from the time of Boerhaave, has been progressively employed
to express organic inflammation, as in cephalitis, carditis, gas-
tritis, and n)Ost similar affections. In this sense, therefore, when
employed at all, it ought to be employed exclusively. And here
the etymological idea is directly consonant with the practical :
for. as observed already, it imports increased and impetuous
action. A few terms only stand in our way, upon this point,
even at present, as rachitis, hydrorachitis, ascites, and tympa-
nites ; all which, however, are of little consequence, as they
have good synonyms, or may be easily varied, as the reader
will perceive in the ensuing arrangement.

Oma has, in like manner, from some cause or other, a gener-
al idea attached to its use, not easy to be explained from its
primary signification : it is that of external protuberance, and
to this, therefore, it should be confined. We meet with this
idea in ecchymoma, staphyloma, atheroma, steatoma, sarcoma,
and carcinoma. It does not easily apply to glaucoma ; but as
this was as frequently called by the Greeks glaucosis,' and by
the Romans glaucedo, we need not be troubled oven with this
slight exception. The therioma of Celsus, though continued by
Vogel, is banished from general use, and if it were not, this
would also admit of a ready change to theriosis.

lasis is almost as generally appropriated in the present day
to denote diseases of the skin, unconnected wilh fever; the
cause of which it seems, also, as difficult to discover as in either
of the preceding instances : but this being the fact, the hint
should be taken and the necessary limit applied. We have
sufficient exemplification of this remark in elephantiasis, leon-
tiasis, p<;oriasis, pityriasis, phthiriasis, helminthiasis, (applied
by Plenck to cutaneous worms and larves of all kinds, except
those of the pediculus, but to which malis is preferable) and
tyriasis, importing in the same author a peculiar variety of 1^-

liv , PRELIMINARY DISSERTATION.

pra. To these we may adcHchthyiasis, as in this case it ought
to be written, instead of ichthyosis. Many of these terms ^re
unnecessary, and may be well spared, but they serve as exam-
ples of the general turn the final iasis has been lately taking,
and to which, whenever it is made use of, it would be right to
attend. Satyriasis, sardiasis, and one or two other terms, form
exceptions to the general tendency ; but they are not wanted,
as will be readily perceived in the ensuing pages ; while all
but the first have been long obsolete, and are almost forgotten.
Hypochondriasis is not, strictly speaking, a Greek term. It is
comparatively of modern origin, and may be conveniently ex-
changed for hypochondrias.

Cele (scnM) retains generally, to the present hour, its original
sense, which is that of " a yielding tumour," especially a yielding
tumour produced by the protrusion of a soft part ; as in bron-
chocele, sarcocele, glossocele, bubonocele. Rhagia (payict) is, pro-
perly speaking, an elision of haemor-r/ias|-m, from putrsr*, " rum-
po," to burst or break ; and hence uniformly denotes a preter-
natural flux of blood by the bursting of one or more blood-
vessels, as in raenorrha8;ia, rhinorrhagia, and enterrhagia.
While rhxna^ (p«) from ^la " fluo," tojlow^ imports, with almost
equal uniformity, a preternatural flux of any other fluid, as in
diarrhoea, gonorrhoea, leucovrhoea, ottorrhoea. In perirrhcea, as
employed by Hippocrates in the sens(; of enuresis, we have an
exception, as we have also in the modern compound menorr-
hoea, which denotes a natural flux, and in a healthy proportion.
But the first has long grown obsolete and yielded lo enuresis ;
and for the second we may employ catamenia, or menia with-
out the preposition, which is totally superfluous, and omitted in
all the compounds of ,«»», as also in the Latin homonyms men-
ses and menstruatio. All these therefore may remain untouch-
ed, and are sufficiently correct in their present use.

Odes (u^iii) uniformly imports " par, similis," like or akin to the
subject with which it is connected, as in typhodes, icterodes,
phlegmonodes : and is probably derived from <»?£. " hoc modo."

///o, ula^ illaris, ularis^ well known as Latin diminutive ter-
minations, are perhaps derived, as will be more particularly
shown hereafter, from the Greek iiM. (yle or ule) " materies,"
and importing, therefore, " of the matter, make, or nature of,"
as in pupilla or pupula, pustula, fibula. These are opposed by
the suffix osMs, uniformly a Latin augment, derived, perhaps like
05J5, above, from aaix, or iwix, "substance, essence, power:"
hence undula is ."a little wave;" undosus, "full of waves;"
cellularis. " having little cells ;" cellulosus, " full of little cells."

PRELIMINARY DISSERTATION. Iv"

This distinction has not been sufffciently attended to by medi-
cal writers, and we have 'in consequence seen the two suffixes
occasionally confounded.

The PREFIXES or initial particles or prepositions have far less
generally departed from their original sense, though many of
them exhibit great looseness, and very different significations.
In grouping them we shall find that «, caco^ dys^ and para^ though
separated from each other by shades of difference, are all pri-
vative or debasing; and that ec, ex, epi, hyper, though separated
in like manner, are all augmentive or elevating. It would be
better perhaps that a should be limited to the idea of total pri-
vation, as in agenesia, or aphoria : but the laxity of its use, not
only through the whole nomenclature of medicine, but the whole
of the Greek tongue, is an effectual bar to such an attempt, as
we may readily perceive in atonia, apnoea, adipsia, asthenia, in
which it is merely debasing or defective : and it is in this sense
that it often becomes synonymous with dys, para, and caco, as
in dyspnoea, paralysis, and cacodia (defective power of smel-
ling). Dys, indeed, in its strictest sense, should convey the
double idea of defect with difficulty or distress, as in dysente-
ria, and dj^smenorrhoea ; and caco the double idea of defect
with corruption or depravity, as in cachexia, cacophonia : but
this distinction has been little attended to. Para occasionally
embraces a wider range than any of the rest, and runs precise-
ly parallel with the Latin male or the Teutonic mes, or mis, so
frequent in compound words of our own and the French tongue.
In anatomy, however, para is often employed in the sense of
apnd ovjvxia, " bordering on, or hard by" — and ig words de-
rived from anatomy it retains this sense in the vocabulary of
diseases, as in parotis, paronychia, with no small confusion to the
learner : and consequently gives a sense that should be other-
wise provided for.

It would be better still to avoid the use of all these prefixes
as much as possible, with the exception of a, which cannot be
spared ; for, where they convey the direct sense of a they are
not w-inted, and, where they convey no other than that of gene-
ral morbid action, they are commonly, though not always, su-
perfluous expletives ; since the science in whose service they
are thus employed, necessarily implies such an idea, as well
without them as with them.

The opposite initials ec, or ex, epi or eph\ and hyper, denote
alike the general idea of otit of, outwards, over, above, in their
primary sense, or when applied to place, as in ectropium, epi-
demicus, hyperostosis ; but that of augmentation or excess in

ivi PRELIMLVARI DISSERTATION.

their secondary sense, or when applied to quantity or quality,
as in ecstaci?, epiphora, hyperuresis.

En is an initial of very extensive range as well as significa-
tion ; and it has this peculiar property, that, in different senses,
it becomes an antagonist to both the preceding groups in the
one or other of their general meanings. In its primary sense,
or as applied to place, it imports within^ below ; as in encepha-
lon, emphysema ; and consequently opposes the primary sense
of ec, epi, hyper : while in its secondary sense, or as applied to
quantity or quality, it exactly accords with these prepositions,
and imports superiority or excess^ and in like manner opposes
the general idea conveyed by o, caco, and dys ; of which we
have examples in enthusiasma and enuresis. En appears there-
fore to be as necessary an initial particle in the medical voca-
bulary as a ; and with these two we should seldom feel at a
Iqss for any other : for as a is capable of supplying the place
of all the rest in the first set, so en is capable of performing the
same office for those of the second. Hypo {iTrm) in its significa-
tion of below or doionzvards, is sometimes called upon to act the
part of an ally, as in hypogastrium, and hypocondriura, and
their derivatives hypogastrocele, and hypocondrias, or hypo-
condriasis ; but this is seldom the case, and at all times ob-
trudes an assistance, of which en is not in want : whence hypo
might easily share in the preceding proscription. In this
general view of the subject, en seems at first sight to be untrue
to itself: but it is not difficult to explain the apparent con-
tradiction. En runs precisely parallel with the Latin alte.
The leading idea of both is " power or precedency ;" and this,
whether the order of advance be from below upwards, or from
above downwards. In measuring rank and station, we take
the former scale, and speak of high posts and dignities ; in mea-
suring intellectual qualities we take the latter, and speak of
profound judgment and wisdom. The Greek en and the Latin
alte are equally applicable to both; and hence it is that in our
own tongue, and, indeed, in most of the dialects of Europe, high
and deep occasionally become synonyms, and the same general
meaning may be expressed by either. In one respect, in-
deed, the Greek and Latin terms differ ; the former importing
depth in its primary, and height in its secondary sense ; and
the. latter importing height in its primary, and depth in its se-
condary sense. In all these cases, however, the difference of
Jhe two meanings^ is easily understood by the context, and it
would be hardly woi;jth while to attempt to limit the Greek en
■o cither sense if we xverc able. En is a short and tractable

PRELIMINARY DISSERTATION. Ivli

initial, and must remain equally to form a contrast with a, and
with ex or epi ; in the former case, to import ascendancy or
superiority, as being applied to quantity or quality, and in the
latter case to import descendancy or inferiority, as being ap-
plied to place; with which distinction before us its meaning
can never be mistaken.

A word or two will suffice for the remaining prefixes. Cata
{zara.) and opo (a-Tro) are two of the most frequent. They have
been very little introduced into nosological terms of late; but
in those of early writers are far more frequent, and exhibit a
great variety of senses ; most of which, however, in respect to
either prefix, are capable of being resolved into the general
idea of iteration or duplicate action, or ideas that obviously
ramify from this fountain, and which are usually expressed
by the Latin and English particle re ; as in catapsyxis, re-fri-
geration ; cataspasma, re-traction ; catamenia, re-menstruation
(importing its regular return); apostema, re-cession, abscession
or abscess ; apothesis, re-placement or reduction of a dislocated
bone. Whence again apo is occasionally used in the sense of
hack or from, as in apogeusia, apositia, backward, tardy, defec-
tive taste or appetite ; while both are far more frequently used
emphatically or in a superlative sense, as importing reduplicate
action or double force ; of which we have examples in catacau-
ma, a burn ; catagma, a fracture ; catalysis, for paralysis, ca-
tarrhus, apoplexia, apocyesis (parturition.) In this signification
both are evidently redundant ; nor are they much wanted in
any other.

Peri{w(fi) continues uniformly true to the sense of aVcwm, and
is limited to terms derived from anatomy, as peripneumonia
and peritonitis. Dia (iiet) is nearly as single in its meaning; or
rather the different significations in which it is used are capable
of being arranged under one leading idea, that of separation,
which is the only idea it should be allowed to convey, if ever
employed in the coinage of new terms. We trace this general
sense in diabetes and diarrhoea, " a passing off, or flowing
through ;" diacrisis and diagnosis, " a judgment or distinction,
by the separation of one symptom from another ;" diastole and
diastasis, " a dilatation or separation of part from part." Syn
(o-v»,) and its derivatives sym and sy, are uniformly expressive
of conjunction or association.

Such are the significations assigned to these auxiliaries when-
ever employed in the ensuing system ; the author has, never-
theless, endeavoured to employ them as seldom as possible,
and always in a definite sense. The clsfssific names are given

H

Ivili PRELIMINARY DISSERTATION.

entirely without them, and the ordinal nearly so. In this re-
spect he has differed from Di: Young, who has prefixed the
preposition para., importing diseased action, to the name of every
class, but the last, in which it is exchanged for ec. But this
seems a pleonasm ; for in a system directly nosological, pu'-a
is necessarily implied in every instance. Neuroses or neurismi
is just as expressive as paraneurismi ; and haemorrhagiae, or
hasmasiae, as parhaemasige. Linneus has been very particular
upon this point ; and has never introduced compound terms,
but when he has thought them strictly called for. In conse-
quence of which we have mentales, quietales, motorii, without
any affix whatever.

But though the author has felt no occasion for these auxilia-
ries in denominating his classes, and but little occasion for them
in the names of his orders, in his generic terms he has often
found it necessary to have recourse to such assistance ; in some
instances because, though evidently redundant, the affix could
not be detached without the appearance of affectation ; but
more frequently for the purpose of distinguishing the names of
different diseases, compounded of the same radical term ; as in
phyma, ecphyma, and emphyma; phlysis, ecphlysis, arid em-
phlysis ; ecpyesis and empyesis, with various others; which,
thus compounded, present, at the same time, their relative points
of accordance and of discrepancy, and are consequently more
easily, instead of less easily, distinguishable.

4. As the component parts of a term ought to be restricted to
a precise and individual meaning, so ought the entire term,
Avhether compound or single. The common signification of
asphyxia is " apparent death," whether from suffocation, electri-
city, or any other cause. Plouquet, in his Initia, has applied
this term to " a temporary suspension of the pulse, while all the
other functions of the system, v/hether corporeal or mental,
continue with little or no interruption." The term in its ori-
ginal sense (aa<^u^ia) pulselessness, will bear Plouquet's meaning,
but it is at the expense of its general interpretation : and hence,
as the disease alluded to by Plouquet has not yet fairly found
a place in nosology, and no other term has been devised for it,
it will be found distinguished from asphyxia in the present sys-
tem by the term acrolismus, of meaning precisely parallel.

There is a strange confusion in the general use of the terms
liemerdlopia.:in(\ nyctalopia. Most modern writers mean by the
first, " vision, irksome, or painful, in the light of noon, but clear
and pleasant in the dusk of the evening;" and by the second,
'' vision, dull and confused iti the dusk, l)ut clear and powerful

PRELIMINARY DISSERTATION. lix

at noon-day." But this is directly to reverse the signification
of both terms, as employed by Hippocrates and the Greek
schools ; and as the Greek sense is still occasionally continued,
there is sometimes no small difficulty, and especially to a learn-
er,, in understanding what diseases are referred to. In the en-
suing system most disorders of the sight, unconnected with in-
flammatory action, are arranged under a common genus, enti-
tled paropsia, of which hemeralopia and nyctalopia become
species ; and as they are here distinguished by the names of p.
lucifuga, and p. noctifuga, it is hoped that the usual perplexity
will be found sufficiently avoided.

JEsthesia^ among almost all the nosologists, imports sensation
generally ; and hence dysjEsthesije is employed by Sauvages,
Vngel, Sagar, and Cullen, as the name of an order, comprising
diseases of sight, smell, taste, touch, and hearing ; running pa-
rallel with the order ^sthetica, in the class neurotica of the
present system. But Cullen, after having used the term as an
ordinal name in this general signification, next employs it as the
name of a distinct genus in the very limited signification of
touch alone, and in contrast with all the other senses ; anaesthe-
sia, the genus referred to, being defined " tactus inmiinutus vel
abolitus." Linneus, indeed, had already used it Avith an equal
restriction, which he ought not to have done, as the term had
been already adopted by Sauvages in its wider and corrector
sense. But Linneus has not fallen into the self-confusion of
Cullen ; for he has not employed aesthesia or any of its com-
pounds in any other import. To avoid this irregularity the
ancKsihesia of Linneus and Cullen is, in the present system, ex-
changed for parapsis.

Exanthema, among the Greeks, imported " cutaneous erup-
tions generally." Sauvages, and all the nosologists doum to
Cullen inclusively, together with most other medical writers,
have limited it to express " cutaneous eruptions accompanied
with fever. ^'' Attempts have more lately been made to fetter it
within a still narrower circle ; sometimes by confining it to
*•' eruptive fevers produced by specific contagion,'^'' whatever be the
character of the efflorescence ; and sometimes by restraining it
to the character of the " efflorescence alone, with little atten-
tion to its being connected or unconnected with fever.'''' It is in
this last view that the term has been employed by Dr. Wilian,
who limits it to the import of the English term rashr'dnd in his
list of definitions, explains the one term by the other. In this
confined use of the word, however, he does not always maintain
his accustomed precision ; for after having, in his table of dofi-

ix rRELIMINARY DISSERT ATIOKT.

nitions, characterised rash or exanthem as distinct from jxipufa
and wheal, he employs exanthemata as the name of an order
embracing diseases distinguished by both these symptoms. In
Dr. Willan's very restricted use of the term there is great in-
convenience, and but little or no authority in his favour ; and
hence in the ensuing system it is restored to its common noso-
logical acceptation.

The limits of the present sketch will not allow the author to
pursue this subject much further ; but it is necessary to observe,
before he entirely drops it, that there are various terms, in com-
mon use in nosological descriptions, whose meaning in like
manner remains in a very unsettled state to the present hour;
and which it will be the object of the ensuing attempt to simpli-
fy and define. As examples it may be sufficient to glance at
the words pyrexy^ apyrexy, paroxysm, accession, exacerbation,
crisis.

Fevers were called by the Greek physicians pyreti, pyrectici
morbi, or simply pyrectica.* Pyrexia, (febricitatio, rather than
febris), was in a looser sense applied to fever generally, but
limited, when more strictly employed, to febrile heat and in-
creased pulsation. The duration of the cold and hot stages was
called its paroxysm, and the interval between one paroxysm-
and another was distinguished by the term apyrexy («7rup6|w).
What the Greeks called paroxysm the Latins named accession,
(accessus, or accessio) ; for the apyrexy of the former, the latter
employed the term intermission (m7erm?55/o), and if the interval
were only a remission, instead of a perfect intermission, the re-
turn of the hot fit was denominated exacerbation (exacerbatio) ;
which in fact is a direct translation of paroxysm ;t so that an
exacerbation was the same correlative to a remitting, as an ac-
cession was to an intermitting, fever. The duration of a single
exacerbation and its remission, or of a single accession and its
intermission, was denominated a febrile period.

Sauvages emploj^s tlie whole of these terms with a pretty
strict adherence to their original meaning ; but by Cullen and
still later writers they have been used with much greater laxity,
and, occasionally, in very different senses. Like many of the
Greek physicians, Dr. Cullen has proposed a difference be-
tween pyrexy and pyhkt:vs or febris ; the former of which terms
he is w'ell .!j.^k)wm to have taken as the name for his first class
of dis"easeso^''Wiiile,^;o\vevcr, he proposes a difierence between

* UupiTOl, ■TTUfii-iTlltdl. Vi(Tilfd,Cttal, TTUflfltrmti.

■■ \Uc^.^u7f/.'.r, " incitntio, cxacerbatio," from TTitfia. ami t^vt aculuf.

ir
w

PRELIMINARY DISSERTATION. Ixi

these terms, it is not that of the Greek schools, but altogether
of his own invention ; for instead of limiting pyrexy, as was
clone by the Greeks when they allowed a distinction, to the
mere symptoms of increased heat and increased pulsation, cor-
responding in a considerable degree with what is now usually
called the second stage of a febrile paroxysm, he has connected
shivering, or the chief symptom of the first stage, with it, to-
gether with the symptoms of " various injured functions, and
diminished strength in the Hmbs."* By this addition, hoAvev
er, he has considerably overshot his own mark ; for he has not
only given a new sense to the term, but has frustrated the dis-
tinction he intended to establish ; insomuch, that when he pro-
ceeds to define fever by its ordinal character he has nothing of
any real importance to add ; for fever in his ordinal definition
of the term is still pyrexy, though pyrexy zvith the comparative-
ly trivial appendage of " previous lancruor^ lassitude^ and other
signs of debility ^wilhout primar. local disease ;"t and hence, more-
over, the term pyrexia, upon his own interpretation, applies but
very indifferently, as a classific name to any of Dr. Cullen's
remaining orders, except exanthemata ; for it is rarely that in-
flammations or hemorrhages, his other orders, are preceded by
shivering, or accompanied with lesion of various other func-
tions than that belonging to the organ affected, although they
usually are accompanied with " increased heat and pulse," or
pyrexy, in the Greek restricted sense of the term. It is not to
be wondered at, therefore, that this distinction of Dr. CuUen
between pyrexy and fever, should have appeared to later wri-
ters as perplexed or nugatory ; and it was probably under
some such feeling that Dr. Parr, and still more recently Dr.
Young, in laying down their respective systems, determined
upon abandoning all distinction whatever, and upon emplojdng
pyrexiae and fevers as synonymous, or rather univocal terms.
It is necessary, therefore, to point out the discrepancy that i«
at present prevailing in medical technology upon this subject.
In the restricted sense in which the term was employed by the
Greeks it seems useful and necessary ; for we have _na other
by which we can so well or so shortly indicate those peciliar
febrile symptoms which connect the family of phlogoses or
phlegmasiae with that of simple fevers ; and it is in this sense,

therefore, as importing the joint idea of febrile heat and aug-

_ : : — .,i»i ^ ' — , ^;''^\ —

* Post horrorem pulsus frequens, calor major, {iluAes func/oncS laesas, viiibus
praesertim artuum itnminutis. fV/ '

t Prsngressis languore. lassitucUne, ct aliis rlebilitafi* signis, pyrexia, sine nioibL>
locali primario.

ixii PRELIMINARY DISSERTATION.

merited pulse, detached from the ideas of shivering, languor,
and various injured- functions, that the term pyrexj will be em-
ployed whenever had recourse to in the ensuing pages.

The term accession has of late years undergone a still greater
change in its meaning than pyrexy. It has been just observed
that accessio or accessus was employed by the Latin writers in
a sense precisely parallel with the Greek word paroxysm;
and that either embraced the cold and hot stages of a febrile
seizure, the only stages into which such seizure was divided.*
And hence paroxysm is a term not to be found in Celsus, who
uniformly employs accessio in its stead.j

Among recent writers, however, and perhaps generally in the
present day, while the term paroxysm is applied not merely to
fever-fits, but to fits of every violent and intermitting disorder
whatever, the term accession is limited to the commencement or
onset of a fit, its insultus, as denominated by the Latin writers ;
and hence Dr. Cullen speaks of the " accession of paroxyms,"J
a phraseology which would be nonsense upon the original
meaning of the terms ; while Dr. Turton, with evident indeci-
sion upon the subject, defines accessio, in his Glossary, " the be-
ginning, or paroxysm of an intermitting fever,'''' (allowing the
reader to take which sense he will) ; and paroxysmus "an access,
fit, or exacerbation of a disease ;'' giving a still greater latitude,
as well in respect to the genus, as the stage of the morbid affec-
tion. The Latin translators of Galen adhere to the original
signification ; and hence what Cullen calls the " accession of
paroxysms," is in their language " incrementa accessionum :"§
and the same import is given to the term access or accession
by Sauvages, who in describing the simple quotidian fever says,
" duratio accessus oc/orfecim haras non excedit:"|| and observes

* The paroxysm iv; "cession embraced the whole course of a fever-fit of whate-
ver length, till its uo'-r'nT'on, which was not accounted a part of the paroxysm;
and hence Celsus diviuct; ''.' • . n?ire range into accessio and deressio. In later times
the declination has been ! il.rn i:iio the general ^iccount; and the course ofa fever
lias in consequence been said i'> krss three stn.(!;es, distinguished by the names
o( insullus or irivasio, decursw. ■ ' declinatlo. The humeral pathologists who
held that fever was an effort of naii ■> throw off from the constitution, by a pro-
cess of concoction, sonic peccant rnu;; '^ tlie form of scum, denominated these
three stnf;cs, after the language of Sydcr.;. . ' orriptlalio, ebullitio, and despuma-
lio. These leims, however, together with nridrcds oi others derived from the
same mint, have long sunk into the grave, with the li\ fothesis that gave rise to them.
So dangerous is it to construct a technical vocabulary iij . .-; basis of hypothesis,

t See especially Lib. iii. cap. li.iii.

:j: " Though the intervals of paroxysms are different in different cases, yet the
\\mp?, oi \\^p, (tcrcssion of jxiroxysms are generally fixed to one lime of the day.
P'irst I/nies, chap. iii. sect. Ivi.

k Miinifestissinie, autem, et in hac febre in invasionibus, atque incremenlis ac-
>reMionum, signum putrefactionis apparct. Gal. de Differ. Fehr. lib, II. cap. iv.
■ II Class II. ord. iii. torn. ii. p. 347.

PRELIMINARY DISSERTATION. Ixiii

of the quotidiana subintrans " accessus ad vigenti qiiatuor koras
ferriie extenduntur."* Even in Cullen the term seems some-
times to be employed as a synonym for paroxysm, as in his
definition of hectict fever, in which accession is opposed to re-
mission or apyrexy ; while in his definitions of the tertianj and
qudrtan,§ iu which the words paroxysm and accession are both
introduced, the latter is designed evidently to import the com-
mencement or first stage of the former, or " the accession of the
paroxysm," as in the passage just referred to ; that which by
Hoffman was elegantly and correctly denominated the spasmus
periphericus^ or general spasm of the small vessels diffused over
the entire surface ; in popular language, the shivering fit.

It is not difficult to account for this confusion of sense : for
notwithstanding the general appropriation of the word acces-
sion among the Latin writers to the whole duration of a fever-
fit, or what is now called a paroxysm, its radical idea imports
simply " advance, approach, entrance, avenue ;" and in this
meaning Celsus himself is perpetually using the term in its
verbal form, and occasionally, indeed, in connexion with acces-
sio in its technical signification, as " donee altera accessio acce-
DAT,"|| " till another accession accedes or comes on."

Fordyce, probably from its complicate meaning, has banish-
ed the term accession altogether, and introduced the phrase cold
Jit in its stead, retaining, however, paroxysm in its modern and
popular sense : so that, according to him, an ephemera is a fe-
ver consisting of one paroxysm, which paroxysm comprises
three stages, '^ a cold fit, hot fit, and crisis.^^ And here we
have a new sense assigned to the term crisis. Among the
Greeks it is very well knov/n to have imported a decision or
determination of the disease ; and hence critical days were,
amongst them, days which produced such decision or determi-
nation. With Dr. Fordyce, however, crisis imports nothing
more than the decision or determination of a single paroxysm
of a disease, its decline or sweating stage. Whilst, by many of
the humeral pathologists, the term was used in a different
sense from both these, and signified, synonymously with the
despumatio of Sydenham, the separation and discharge, of the

* Class II. Old. III. torn. ii. p. 347. '

t Febiis quotidie revertens, arcessionibus mcridiauis et vcspertinis, remissioru .

laiius apyiexia matutipa. Gen. vi.
:j; Paroxi/smi similes, intervallo quadragiuta octo circiter horaiura ; accessiotii-

bus nieridianis. Gen. i.

i Paroxi/smi similes, intervallo septuagiuta duarum circiter horarum ; acc€S.rio:ri
bus pomeridianis.

II Lib. 111. cap. iii.

Ixiv PRELIMINARY DISSERTATION.

crude and morbid material which was the supposed cause of
fevers, without any reference to particular days, or particular
stages of a paroxysm.

It is high time, then, that an exact sense should be fixed for
the whole of this group of terms; and with a view of accom-
plishing this object, as far as he is able, the author will be
found in the ensuing pages uniformly to employ, \. paroxysm,
as importing the entire duration of a fit of acute disease of any
kind, whether the interval be perfectly or imperfectly free : 2. '
cxacerhation, as signifying the paroxysm of a disease, whose in-
tervals are merely imperfect or remissive ; which is the strict
meaning of paroxysm when literally rendered : and, 3. acces-
,j8('on, as indicating the commencement or onset of an exacerba-
tion or paroxysm of any kind ; which restores the term to its
radical idea ; whilst he has omitted the use of the term crisis,
as neither wanted nor conveying in the present day any deter-
minate sense.*

II. But it is an object of the ensuing pages to attempt an im-
provement in the arrangement of diseases, as well as in the
LANGUAGE employed to describe them.

A knowledge of the animal frame involves a deep and com-
prehensive acquaintance with three distinct branches of natu-
ral science ; anatomy, by which we become acquainted with
the structure of this frame ; physiology, which teaches us its
various functions ; and nosology or pathology, which unfolds
to Us the diseases to which it is subject. Unfortunately each
of these branches has hitherto been taught by a different,
instead of by a common, method ; and hence the student, in-
stead of proceeding with each at one and the same time, and
with a single expenditure of labour, is compelled to apply him-
self to every one separately, and by a kind of new and uncon-
nected grammar.

The great and comprehensive mind of Haller w^as forcibly
struck with the expediency of uniting the whole into one com-
mon pursuit. In his " First Lines" he gave scope to his feel-
ings upon this subject ; and since his day various efforts have

* It may not be improper to mention here, that where foreign words are fully
adopted into En-^lish, and used with an Englisii termination or inflexion, the au-
thor tias spejt^ein, in the ensuing pages, agreeably to the rules that regulate ver-
Jthusi pretcrnulnral is used instead of jir(rternatural, after the man-
rid 7>,rc<'''icc ; edvmrilous instead of cfdcmatoits, after the manner of
'^stck(Y(ftgas or i;az, after the manner of all similar monosylla-
ufSubstaniivcs ; -.is i;;lass, grass, pass, bliss, 7niss, loss, cross,
Tjli frhm fto, " to bring forth," is the old, and, perhaps, the
n ryrn in Latin, instead ol fa.tvs of later date.

JPRELIMINARY DISSERTATION. ixV

been, made to concentrate the studies of physiology and ana-
tomy. Much, however, still remains to bring even these two
branches into that state of close contact and parallel investiga-
tion for which they are so admirably titted, and which would
equally add to the perfection of both : while the view which
has just been given of the general history of nosology, affords
a sufficient proof that no systematic step whatever has hitherto
been taken to incorporate the elementary study of animal dis-
eases either with that of the animal structure or the animal
economy.

To accomplish such an incorporation is the object of the en-
suing system; the whole edifice of which will be found to be
erected on a physiological basis ; and to run parallel with the
divisions into which the science of physiology most usually
ramifies. The track is new ; and difficulties of no ordinary
magnitude have been encountered in the prosecution of it^
The author does not flatter himself that the whole of these are
by any means removed in this first attempt : but he trusts that
he will be found to have pointed out a useful though an unex-
plored course, and that future pioneers may be able to level
and complete, what he may thus far have left rugged and un-
mastered.

Having conceived the possibility of a nosological system,
whose primary divisions should take a physiological range, and
follow up the diseases of the animal fabric in the order in which
the physiologist usually developes its organization and its func-
tions, the author had next to determine at which end of the se-
ries he should begin ; whether, with Haller, at the first and
simplest vestige of the living fibre, and pursue the growing ens
through all its rising stages of evolution and elaboration to its
maturity of figure and sensation ; or, with the physiologists of
later times, to take at once the animal frame in its mature and
perfect state, and trace it, from some well-defined and promi-
nent function, through all the rest; which, like links in a circu-
lar chain, may be said to issue from it, and to be dependent on
its existence and properties.

The author Avas soon led to a pi-eference of the second
scheme. It is by far the simpler of the two, and directly har-
monizes with the fundamental principle, w'hich runs through
all (he systems of zoology, botany, and mineralogy^, of forming
the arrangement and selecting the characters Mrtn^haAiost

t

n

perfect individuals as specimens. He d ecidgd,^ tha^feri
taking the more prominent functions of the hum|MH||||iS*^.his
primary or classific division, and the more uy^^pi^lSil^tJb'eir
I

Ixvi PRELIMINARY DISSERTATION.

respective organs for his secondary or ordinal ; and without
tyeing himself to a particular distribution of the former in
any authorized or popular use at the present moment, to follow
what appears to be the order gf nature in her simplest and
most intelligible march. ;'

To repair the exhaustion which is constantly taking place in
every part of the body from the common wear and tear of life,
it is necessary that the alimentary canal should be supplied
with a due proportion of food, the procuration of which, there-
fore, constitutes in savage as well as in civil society, the
first concern of mankind. The food, thus procured is intro-
duced into a set of organs admirably devised for its reception ;
and its elaboration into a nutritive form constitutes what physi-
ologists have denominated the digestive function. The dis-
eases then to which this function is subject will be found to
create the first class of the ensuing system.

The food thus far elaborated has yet to be conveyed to the
lungs, and be still further operated upon by the atmosphere,
before it becomes duly assimilated to the nature of the fabric
it has to support. The function of respira-jion embraces this
part of the animal economy ; and the diseases to which this
function is subject form the second class of the arrangement.

The blood now matured and consummated is returned to the
heart, and sent forth, in a circular course, to every organ of
the body, as the common pabulum from which it is to secern
what it stands in need of : the waste blood being carried back
to the fountain from which it issued. It is this circulatory track
that constitutes the sanguineous function; and the diseases by
which it is characterised form the third class of the ensuing
pages.

But the blood does not circulate by its own power. From
the brain which it recruits and refreshes, its vessels (perhaps
itself) receive a perpetual infliix of that sensorial energy which
gives motion, as the blood gives food, to the entire machine ;
converts the organized into an animal and intellectual system,
and forms the important sphere of the nervous function. This
function, also, affords scope for a large family of diseases ; and
hence we obtain a ground-work for a fourth class upon the plan
before us.

Such is the progress towards perfection in the life of the in-
divicl^al. But man is not born to be an individual; he is de-
signed C(iifpcr\yfi^aAc his species; and the last finish to his frame
consists in giving full develoj)ement and activity to the organs
which are subservient to this purpose. We now arrive at the

PRELIMINARY DISSERTATION. Ixvil

SEXUJlfc FUNCTION ; and obtain from the diseases by which it is
marked a fifth class for our use upon the present occasion.

As every part is thus receiving new matter from the blood,
it is necessary that that which is superseded should be carried
oft'- by proper emunctories : as it is also necessary that the an-
tagonist processes of restoration and detrition should maintain
a fair balance. And hence the minute secretory and absorbent
vessels hold the same relation to each other as the arteries and
veins, and conjointly create an excernent function ; whose
diseases lay a foundation for the sixth class of the ensuing sys-
tematic attempt.

It will yet remain to create a class for external accidents,
and those accidental misformations which occasionally dis-
figure the fetus in the womb. This will constitute the seventh ;
and under these seven classes it will possibly be found that all
the long list of diseases may be included which man is called
to suffer, or the art of medicine to provide for.

The succession is here easy and natural : every class, at
least with the exception of the last, leads immediately to that
which follows it ; and the student will at once comprehend its
scope, and readily retain its arrangement. The order is strict-
ly physiological ; but it is not exactly the order which has hi-
therto been laid down by any of the writers upon this subject,
as it is more simple than that of most of the systems, and more
catenated than that of several. Daubenton's, which, if not the
earliest, is one of the earliest of those entitled to the character
of a system, is unnecessarily extensive and complicated for a
medical purpose, though highly ingenious and useful in a zoo-
logical view. In this the chief divisions are taken from the or-
gans rather than from the functions, which is an inconvenient
arrangement, and not altogether scientific. Dumas improved
upon this plan ; but it is to Vicq-d'Azyr that we are indebted
for the first perspicuous attempt upon a basis of functions ; and
his attempt has been rather enlarged than matured, by several
later writers, and particularly by M. M. Richerand and Bi-
chat. Under Vicq-d'Azyr the order of succession is nearly
the same as in the present classification, with the exception,
that it closes with sensation instead of Avith secretion ; but the
number of general functions instead of being limited to six is
extended to nine ; the additional functions being those of nutri-
tion, ossification, and irritability; of these, however,, the 'two
last have been rejected by Richerand and Bi?hlitVand*he offices
they refer to, merged in the excernent and nervous functions :
by which means the system of the. former is reduced to the

Ixviii PRELIMINARY DISSERTATION.

present scale, with the exception of the office of nutrition, or
the conversion of the common food of the blood into the sub-
stance of the various organs to which it is applied ; but which,
if accurately examined, is as strictly a part of the excernent
function as ossification, or the nutrition of the bones, which
these physiologists have correctly transferred to this division
of the animal economy. The process of growth or nutrition,
is, in reality, that of secretion : every organ secerns for itself;
it separates alike what is proper to be parted with as waste
matter, and what is proper to be received as a restorative and
augmentive subsiance. It throws off the first, and assimilates
to itself the second. And hence the processes of secretion and
absorption are but parts of a common function : conjointly they
form a circle, and as it has been already observed, hold the
same relation to each other as the offices of the arteries and
the veins.

But though M. M. Richerand and Bichat have in these re-
spects simplified the arrangement of M. Vicq-d'Azj^r, they
have upon the whole considerably widened and complicated it
by a partition of several of his primary divisions, which they
still retain, into separate functions : in consequence of which,
while Richerand gives us thirteen distinct general functions of
the animal economy, together with an appendix, Bichat ex-
tends the list of functions to not less than twenty. Whatever,
therefore, be the merit of these minuter arrangements, it must
be obvious that they are not adapted to the present purpose;
and it is unnecessary to pursue them further than to observe
that some of the additional matter they contain is derived from
the functions of fetal life ; and that this, so far as it relates to
organic deformity, runs parallel with the seventh class in the
arrangement before us.

The ordei's in this arrangement are taken from what the au-
thor hopes will be found an easy distribution into natural groups
of the organs that appertain to the classific functions, with the
exception of the third class, in which they are derived from the
peculiarity of the vascular action, and the temperament of the
circulating fluid.

Some of the genci-a are new, for the purpose of enlisting un-
der so many common banners diseases which have hitherto
been held as distinct genera, but which ought rather to have
been regarded in the light of mere species : as adipsia, and po-
lydipsia ; the several diversities of morbid appetite, as bulimia,
anorexia, pica, cardialgia ; the numerous family of visceral in-
flammations, as pleuritis, gastritis, peritonitis; the cxanthcms

PRELIMINARY DISSERTATION. Ixix

■distinguished by a .r;Asli erupiion, or a vesicular eruption, with
various others; by which the study of nosology will be ionnd
simpUfied, and, in some sort, abbreviated, rather than perplex-
ed and protracted. In proof ot which it may be sufficient to
remark, that on reckoning up the number of the genera under
which, upon the present system, all the diseases of the aniiial
frame are reducible, and which the author has never done lill
this moment, he perceives that they do not quite amount to a
hundred and thirty. It is easy indeed to make a genus too
lax and extensive, and to associate under its name species
which have no analogy with each other; and several of our
latest nosologists, in the laudable endeavour to avoid the frit-
tered and dislocated arrangement of some of the earlier syste-
matic writers, have run into this extreme. The aim of the au-
thor, however, has been to steer in the midway of the two; to
generalize as far as the thread of connexion will allow ; but
never to congregate where its continuity is broken off.

Every nosologist has felt more difficulty in distinguishing
between species and varieties, than in forming classes and ge-
nera. And it is here, indeed, that the deficiency of our noso-
logical classifications is chiefly conspicuous when compared
with those of plants or animals. Yet in many cases the line is
as distinctly laid down, and may be as accurately followed up.
Thus in Dr. CuUen's system, variola or small-pox is made a
genus, and the distinct and confluent kinds are termed species.
" But as infection from the distinct kind frequently produces
the confluent kind, and that of the confluent kind frequently
produces the distinct, it would seem more analogous to botani-
cal arrangement to call the distinct and confluent small-pox
varieties than species. Because the species of plants in bota-
nical systems propagate others similar to themselves; which
does not uniformly occur in such vegetable productions as are
termed varieties."* And it is equally clear that variola should
be regarded as a species, and not a genus : since otherwise
the classification would lose one of its most important links,
and the varieties be without a disease to belong to ; for a ge-
nus is no disease whatever, any more than it is an animal or a
vegetable.

In many instances we can trace the variety to arise from
some local peculiarity, as of soil or climate: and this, too, as
clearly among animals as among plants. Thus the sheep, that
in Europe produces a woolly coating, in Angora and some other

* Darwin. Zoonom. Part II. Pref.

I XX PRELIMINARY DISSERTATION.

parts of Asia Minor, has this coating converted into a glossjr
silk ; and in the opposite coast of Africa into a coarse hair.
So the Cuba swine which were imported into that island, in
1509, from an European stock, have nearly doubled ther? ori-
ginal size, and have acquired the singularity of a broad solid
hoof, instead of having a cloven foot. These diversities are
striking : but they are not more so than the symptoms which
accompany the erysipelas in a bleak northern village, when it
assumes a phlogotic or phlegmonous character, and in a south-
ern crowded metropolis where it must be treated with cordials
and tonics : or those which distinguish the gout in a firm and vi-
gorous constitution which violently drives off the disease by
the outlet of a hand or foot ; and in a delicate and atonic frame
in which it wanders from organ to organ for an indefinite term
of time, assuming every day a new disguise, and though less
violent in its action, far more mischievous in its effects. Under
the greater number of nosological systems these diseases are
ranged as distinct genera, and the diversities they thus exhibit
from peculiar circumstances, form so many species. Upon
the common principles, however, of botanical and zoological
systems, the former ought only to be regarded as a species,
and the latter as the varieties incidental to them. The author
has endeavoured to adhere to these principles as far as possi-
ble ; and, hence, whenever the symptoms of a disease are
merely diversified by peculiarity of constitution, of local attack,
or of any other casualty, the new features are only considered
as forming a variety, and not a separate species. Yet it must
be acknowledged that the line of distinction upon this point, is
frequently less clear in the distribution of diseases than in that
of plants and animals; though it may possibly vie with that in
the mineral kingdom.

It is not easy at all times, after having defined a species, to
determine to what genus it ought to belong : for as the spe-
cific character is, in most cases, formed from a combination of
symptoms, it often happens that several of these symptoms
enter into the definitions of two or more genera, and the same
difficulty is sometimes felt in assigning to a genus its proper
order. Thus yaws (frambwsia as it is commonly called) which
by Cullen is introduced into the order impetigines of the class
CACHEXIA, is proscribed from this order by Sauvages, and ar-
ranged under that of tubera of the same class. In effect it
has characters which may give it some claim to either order :
but its most prominent marks, as traced by Dr. Ludford and
other late writers of the best authority, seem far more closely

PRELIMINARY DISSERTATION. Ixxi

to connect it with exanthems, in consequence of which it will
be found under this order in the class pyrectica of the pre-
sent system. The same perplexity has been felt concerning
pestis, Vogel inserts it in the order of tebres, Sauvages, Cul-
len, and Parr, in that of exanthemata ; Cullen, however, pro-
fessing his doubts as to which order it more immediately
belongs ; and Parr distinctly declaring, in a subsequent part
of his Dictionary, that it is improper to arrange it as he has
thus done in the part just adverted to ; and, on another occa-
sion, that there is no foundation for regarding it as an exan-
them, and that it ought to be reduced to a variety under the
asthenic remittents.* Chlorosis has symptoms which connect
it with what have hitherto been called cachexies, with moro-
sities or waywardnesses of the stomach, and with sexual orgasm.
Till the time of Cullen it was generally arranged under the
first head ; by him, however, it has been transferred to the
class neuroses, order adynamic, being still allowed the rank
of a genus. In Dr. Young it occurs as a mere species of dys-
pepsia, in Dr. Parr as a species of a genus which he calls an-
epithymia. In Macbride, who seems to have taken the most
correct view of its relative bearing, it is restored to the rank
of a genus, and deposited in the class and order of " Sexual
diseases proper to Women."

In such difficulties as these, however, there is nothing pecu-
liar to Nosology. In systematic Mineralogy they are more
common ; as frequent perhaps in Zoology; and by no means
unfrequent in Botany. Thus the myxine glulinosa^ which by
Linneus was regarded as a worm, has been introduced by
Bloch into the class of fishes, and is now known by the name
of gastrobranchus ccecw.f, or hag-fish. So the siren v/hich was
at first contemplated by Linneus as an amphibious animal,
was afterwards declared by Camper and Gmelin to be a fish,
approaching the nature of an eel, and was arranged accord-
ingly. It has since, however, been restored, from the class of
fishes, to that of amphibials; and in the present day is believ-
ed by various zoologists to ije nothing more than a variety of
the lizard. In like manner the ipecacuan plant which has
been successively described as a species of Paris, of euphor-
bia, of conicera, of viola, and, by Mutis and the younger
Linneus, of psycotria, is at length clearly ascertained by
Schroeber to belong to the genus callicocca. The angustura-
tree which till of late, was commonly regarded as a species of
Brucea, has been proved by Bonpland to have little relation

*.See Note on the Genus Anthracia, CI. III. Ord. III. of tho present systeigB,

Ixxii PRELIMINARY DISSERTATION.

to this genus; in consequence of which he has formed a new
genus, to which he has given the name of Casparia, for the
purpose of receiving it, referring us for a full description of
the species to the superb work which M. Humboldt and himself
have been long preparing for the press under the title of
Plantes Eqvinoxiahs. At this moment the cascarilla plant is
equally vacillating between the two genera croton and clutia
or clu3'iia ; and, of the upases of Java, and especially the bo-
han upas we have received no specific characters whatever ;
and consequently i<now nothing of their relative places.

In all cases of this kind we must wait for additional in-
formation, and in the mean time exercise our judgment upon
the best, intelligence we can obtain ; cori'ecting what is wrong,
and confirming what is doubtful, as we have opportunity.

It is not probable that some future nosologist (should the
present work have any pretensions to futurity) may be able
to assign more correct places to several of the genera or spe-
cies of the ensuing arrangement than those they now occupy.
It should be well remembered, however, that the principle
6f this" arrangement consists in determining the proper class
of a disease from the general function that is injured, and
not from the particular organ^ which only regulates the subor-
dinate divisions : and that, where two general functions are in-
jured at the same time, that constitutes the class which ap-
pears to be most prominently affected. Thus strophulus, and
scabies, which seldom extend deeper than the secretory ves-
sels of the skin, belong necessarily to the class eccritica, or
that comprising diseases of the excernent function ; while va-
riola and rubeola, though equally occupying the surface, be-
long to the class h^matica, or the diseases of the sanguineous
function; which, in both these cases, is primarily and chiefly
affected, as is obvious from the pyrectic action of the heart
and arteries. So while gastritis and enteritis belong also, as
inflammatory affections, to the haematic class, dyspcpsy and
cholera, though disorders of the same organs, must necessa-
rily be referred to the class cgeliaca, or (hat comprising the
diseases of the digestive function, this being the part of the
animal economy which is hereby chiefly or wholly disor-
dered.

It may perhaps be objected that this is to travel over the
same region a second or evei\ a third time. It is, however,
always In pursuit of a difiercnt object. It is to follow up the
family of diseases that appertain to a particular fimction ;
while. io avoid having our attention distracted, wc leave every

PRELIMINARY DISSERTATION. Ixxiil

Other, function and the diseases belonging to it, untouched.
We pursue the same plan in Zoology, in Botany, in Mineral-
ogy. In a common region we discover discrepant specimens
and bring them home at different times ; exploring it on one
occasion for one purpose, and-^on other occasions for others :
and we then separate and arrange the productions into diife-
rent classes and orders for scientific study, notwithstanding
that nature has produced them in a common quarter.

As simplicity is an object which ought never to be lost sight
of, it is always more praiseworthy, and espetially in Nosolo-
gy, to diminish than to multiply genera, or even the higher di-
visions of orders and classes, wherever this can be accom-
plished with an equal retention of perspicuity. The ensuing,
system has aimed at simplification in these respects ; and it is
on this ground the family of dolores, or local fains, is en-
tirely suppressed, and the genera or species of which it has
ordinarily been composed, are distributed, as mere sympto-
matic affections, under other heads. At first sight local
PAINS seem to form a natural group; but when, cjeqftiy.ed
by the comprehensiveness of the term, we attempt to com-
bine them under a family character, we at once discover
that they have seldom any thing in common, 'wliether in
regard to origin, sensation, effect, or mode of treatment ;
that the connexion is merely verbal, and that they slip
away from us insensibly into some other divisions. Hence
%vith the exception of odontalgia, and another individual or
two, Dr. Cullen regards the whole as entirely symptomatic ;
while odontalgia is with him, in fact, a mere species of rheu-
matism, though advanced to the rank of a distinct genus. Parr,
while writing the earlier part of his Dictionary, had a strong de-
sire to form an order of this kind, and a full persuasion of its ex-
diency. "When we explain," says he, in his article cephalal-
gia, " the arrangement of diseases, we shall find it difficult to
avoid an order^ at least, of dolores ; and under this head ce-
phalalgia must be arranged.-' But when, in the article noso-
logy he carries his arrangement into execution, we find him
compelled to abandon this intention ; in consequence of which
we have no such order as dolores, nor any notice whatever of
cephalalgia, or even of hemicrania.

Even of those who have retained the order, evei-y one seems
to have laboured under the greatest difficulty of fixing ^ts con-
tents and boundaries. Sauvages, Linneus, Vogel, and Sagar,
make it a class ; the first allotting to it thirty-three generai;,tbe
second twenty-five, the third forty-six, the fourth thirtyitw'O. ■

K

Ixxlv PRELlMINAKi DISSERTATION.

In Macbride and Crichton it occurs as an order : the former
giving only twelve, and the latter only eleven genera under it.
Dr. Young reduces it to a single genus, under the name of au-
talgia, and assigns to it not more than three species, a. dolorosa,
the subdivisions of which (they cannot be called varieties) are
numerous, and include many of the preceding genera; a. pruri-
ginosa ; and a. Vertigo : the whole of which, as observed already,
have little analogy in cause, effect, mode of sensation, or plan
of treatment. The subdivision a. pruriginosa was first introdu-
ced by Sauvages, continued by Linneus, Vogel, and Sagar;
thrown out by Macbride and Crichton ; and then taken up
again by Dr. Young. In Sauvages and Sagar, anxietas, lassi-
tude and catarrhus are regarded as dolores ; Vogel banishes
the two last, but preserves the first. Linneus, and every other
nosologist has banished all three. The four last writers as-
sign to this division rheumatism, gout, and lumbago, and per-
haps with as much reason as any other aft'ection. Crichton
dismisses all these. Young dismisses rheumatism and gout,
but retains lumbago and ischias as varieties ; whilst both are
again introduced as varieties under rheumatism, which is made
a species of cauma or inflammatory fever. It was not merely
therefore from the compressed nature of his classification that
Cullen proscribed the division altogether; for it is obvious that
no two nosologists have been able to concur in the individual
diseases that should compose it.

III. In order to render the present work more useful, and
to assimilate it more closely to works of the same kind in the
collateral branches of natural knowledge, to the systematic
name of every disease is subjoined its chief technical and ver-
nacular synonyms. This is a new attempt, and occasionally
accompanied with no small difiiculty. The vernacular syno-
nyms are confined to the three most popular languages of Eu-
rope, English, German, and French ; for these seem to be suf-
ficient. The technical synonyms are in like manner derived
from the three most extensive languages of antiquity, Greek,
Latin, and Arabic : the last of which are given as well in Ara-
bic as Roman characters,* in order that the reader who is ca-
pable of comparing the two characters, may see the peculiar
power which, in the present rendering, is assigned to the latter;
for so dift'erent is this power as assigned at times by different
individuals, and particularly when of different countries, that
the same word is often spelt in such a variety of ways as occa-

*In the present edition, the Arabic characters are necessarily omiticcl.

PRELIMINARY DISSERTATION. IxXV

sionally to defy all collation, and to render it almost impossible
to determine what is the Arabic term, or the Arabic charac-
ters intended to be expressed. Occasionally where the Arabic
names are also Persian or Turkish, the author has added the
initials or other marks of these cognate tongues^ and, in a few
instances, in which they are peculiarly expressive, he has also
superadded the Persian or Turkish names even though differ-
ent from the Arabic. At times, indeed, the Arabic writers
themselves employ a Persian or a Syriac term, for several of
them were of Persian or Syrian birth ; and in such cases the
author has also indicated the proper origin : all which has
been a labour of no small trouble, from the novelty of the at-
tempt, and the difficulty of procuring medical Arabic and other
eastern books that would answer the purpose.

In Sauvages and several of the German nosologists we have
the Arabic synonym given occasionally, but never otherwise
than in Roman characters, and these not unfrequently with
great inaccuracy. In Dr. Willan's description of cutaneous
diseases we have a somewhat fuller reference to the Arabic
synonyms, still written, however, and confined to the Roman
characters, sometimes spelt with, and sometimes without a pre-
fix of the definite article, sometimes with a continental, and
sometimes with a vernacular pronunciation, from the learned
author's not being acquainted with the Arabic language, and
having industriously caught up the words and descriptions as
he was able.

It appears high time, therefore, to give more completion to
this branch of medical synonymy than has, hitherto, been
attempted ; and especially considering the taste which, in the
present day, is evinced throughout almost every kingdom in
Europe for a revival of Arabic literature, and more particular-
ly in our own country and its vast oriental dependencies. The
Arabic tongue is the oldest living language in the world : it
was polished to a very high degree of classical perfection as
early at least as the age of Moses, (supposing, as is generally
allowed, the book of Job, which is Hebrew tissued with Arabic,
to have been written by him;) it was certainly studied and cul-
tivated, as the language of polite science, at the splendid court
of Solomon ; was the chief depository of learning, and particu-
larly of medical learning in Europe, as Well as in Asia and
Africa, during the dark ages ; and has descended as a living
language without any great variation to the present day. The
first translation of Euclid into English was not from the original
Greek, but from an Arabic version, the work of the monk Ade,

Ixxvi PRELIMINARY DISSERTATION.

lard in the twelfth century, who, with various other ecclesiastics,
travelled abroad for the laudable purpose of obtaining knowl-
edge, and studied progressively in Arabia, Egypt, and Spain ;
which last country alone, as it appears from the account of the
Arabic manuscripts of the Escurial, drawn up by the learned
Casiri, possessed at this era not fewer than seventy public libra-
ries ; evincing a wonderful patronage of literature by the Ara-
bian princes, when copies of books were peculiarly scarce, and
enormously expensive. On the resurrection of science, there-
fore, towards the fifteenth century, it was from Arabic sources
and the Saracenic schools, that Europe again became acquaint-
ed with the treasures of the medical writers of Greece. The
illustrious caliphats of Bagdad, Cairo, Cordova, and Fez, had
long rivalled each other in giving encouragement to men of
learning, and especially to physicians, whose profession, what-
ever might be their religious tenets, was the surest path to dis-
tinction and riches. And such was the success attendant upon
this encouragement, that the colleges of Bagdad alone are said
as early as the eighth and ninth centuries, to have contained
not less than six thousand students at a time.

One of the first and most valuable writers in the extraordi-
nary period before us, was Honain Ebn Isaac. Having made
himself master of all the accuracies and elegancies of the Ara-
bic tongue at Bassora, where it was supposed to be spoken in
the highest classical purity, he complied with the munificent
invitation of Almansor, or rather of his grandson Almamon, fix-
ed himself at Bagdad, and among other works, translated the
Aphorisms of Hippocrates with the Commentaries of Galen ;
giving them in Arabic instead of Syriac, which at this time
was the ordinary channel of translation, and that in which the
works of Mesueh were already written. Serapion was con-
temporary with him ; and his productions, many of which are
intrinsically valuable, were composed in the same tongue, and
enriched from the same source. We perceive the same vein of
study running through the writings of Avicenna, Avenzoar,
Theophail, and Averroes. Hence the general doctrines of the
Greek pathology were every thing, and all diseases were re-
solved into the four classes of a sanguineous, a bilious, a phleg-
matic, and a melancholic temperament ; or as they are denomi-
nated in their own tongue, keshi scrkh, keshi zerd, keshi sepid,
and keshi sijah. It is said, indeed, that the Arabian jihysicians
have interwoven with the doctrines of the Greek schools a vast
mass of luml)er derived from their own religious tenets. In
many instances the assertion is true ; yet several of the writers
were Christians, as Mesueh and Honain, and others Jews, as

PRELIMINARY DISSERTATION. Ixxvil

Ben Maimon, or, as he is often called, Maimonides : while not
a lew ot them evince a very correct judgment and clear dis-
crimination, as Avenzoar, who was peculiarly characterized
by his rejection of useless theories. Several of them, more-
over, are well worthy of study as being the oiiginal delinea-
tors of diseases common to our own day. No one ought to
pretend to a scientific acquaintance with cutaneous affections,
who has not studied Serapion ; nor with a practical history of
small-pox or the diseases of children, who has not read the
pages of Rhazes, and especially his Almansor, in which the
former is, not indeed for the first time described, but for the
first time described tcith accuracy : nor ought he to be unac-
quainted with the Maleki of Haly Abbas, in which the writings
of Mesueh, Serapion, and Rhazes, are critically examined and
commented upon. The direct ohj; ct of the present attempt
will not often allow the author an opportunity of making those
occasional remarks on the Arabian writers which he would
like to indulge in : but he may possibly find such an opportu-
nity in a future work on general pathology.

It may not, perhaps, be absolutely necessary to learn the
Arabic tongue for this last purpose, as many of the productions
referred to may be perused in an English translation ; but a
knowledge of Arabic, independently ot its becoming a growing
fashion, will throw a just and satisfactory light on a variety of
technical terms imported from this quarter into our vocabula"
ries of medicine, botany, and chemistry, which we cannot so
well obtain by any other means. Thus chimia^ and conse-
quently alchimia, are Arabic words, without the change of a
letter; the original characters being, and the radical idea im-^
porting '' incorporeal substance or essence ;" a something that
eludes the senses ; and hence, in a secondary sense, " cloud,
mystery, deception." Jsfucha is from the same source, nuka or
nucha, and signifies medulla spinalis, and, emphatically, its
origin or commencement, to which part of the organ the term
is applied in the technical language of the present day. To
these may be added rob, the old pharmaceutic term for inspis-
sated juice, and which is the exact meaning of the Arabic rob :
jasmine (jasmin) the plant of this name, originally brought from
the East ; and asarum (asarun) importing astringency, and em-
ployed in Arabic pharmacy for this quality ; the common, but
erroneous, derivation of which, however, is from « neg. and
rttifw "to adorn;" because, say the lexicographers, it was not
admitted into the ancient coronal wreaths; though from the
unsatisfactory nature of this etymology, others, nearly a& ex-
travagant, have been proposed, which it is unnecessary to

ixXViii PRELIMINARY DISSERTATION.

quote. So julep or julapium is the Arabic, or juleh or julleb,
by the Persians, into whole language it has also been admitted,
written gulab ; and imports literally a sweet medicated drink.
Kali and alkali^ commonly supposed to be Arabic, are Persian
terms., and kalia and alkalia, tar more euphonous names than
the indeclinable nouns in general use, and signify the ashes of
marine plants ; whence the Turks employ kal for ashes in
general as well as their lixivium. It is from the Persian tongue
also we obtain bezoar, or bezoard., properly ped-zahr and lit-
erally depellens venenum^ or alexij harmacon — as also numerous
other terms, which it would be unpardonably digressive to enu-
merate in the present dissertation. Berberis, the Barbary
tree, Enberharis, is Arabic, Persian, and Turkish ; or rather
an Arabic term that has spread through all the dialects of Asia
as well as of Europe.

It is easy, therefore, to trace the path by which Arabic and
Persian terms, and even terms from other Oriental sources,
have found their wa}?^ into the medical and botanical vocabula-
ries of the present day. Nor is it very difficult to show that
the Greeks and Romans have also been considerably indebted
to the same quarter for many words which enter into the com-
mon structure of their respective tongues ; the radical meaning
of which can only be explained by a knowledge of the Orien-
tal dialects from which they have been borrowed. The San-
scrit has, perhaps, contributed most, but almost all the Asiatic
languages have contributed something.

Thus the Latin grammarians are totally at a loss for the
etymology ofaeger, 8eeTa,aegre ; Festus gives us «< mi; Scaliger
rtepye? ; others an/ypas, uixncfoi, and terms still more discrepant in
sense and sound. The reader will, perhaps, readily perceive
the proper origin of this term when he finds, as he will do in
the ensuing pages, that ekrah, by the Turks pronounced egrah,
is Arabic for " sickness, aversion, nausea, horror, or shudder-
ing."

Let us take another example. The Latin tongue has two
distinct terms to express the organ of the liver, hepar and jecur.
The first is easily referred to the Greek wa/i ; for the second
the critics have scarcely a guess to offer. It is in fact a Per-
sian term, jekur, which has been copied into Turkish as well
as into Latin ; in the former being pronounced jcgur. It is not,
however, Arabic, which gives us /ce6erf, doubUess from the He-
brew, 133 ; whence also the Syriac (kebcda.)

It is from (he Hebrew that we obtain the common adverbial
prefix.Au, or bo, importing magnitude or intumescence, as in bu-
^=mir' '-or boli'-miis, as it is written by Gordon, bubo, bubonocele.

PRELIMINARY DISSERTATION. Ixxix

J5u, in Hebrew y^ f)v nyi imports "swelling, bubbling, infla-
tion ;" and hence the same term, in its duplicate form, y^yi
(bobo or bubo) signifies in Ezek. ch. ix. a large ichorous or
pustulous tumour or bubo, and by the Septuagint is rendered
^A«t/5, which embraces both ; as does the word blain in our
vernacular version, which might with strict propriety have re-
tained the original word bubo. Bu is commonly derived from
the Greek Cous, bos, as being a large animal ; but this is to ascend
only half way to the fountain, for Qov? or Sai?, bos, boa, bubulus,
and various other terms, of the same family, are equally deri-
ved from the Hebrew root.

Coryza, more literally koryza, («ogf^«) is a term of Hippo-
crates, to express gravedo, or cold in the head. The gramma-
rians have hunted in vain for its derivation, and it is now usu-
ally allowed to stand in the lexicons as a Greek radix. It is
found, however, almost all over the East in tongues and dialects
of higher antiquity than the Greek, imporMng uniformly cold
or the effects of cold. In Hebrew it is i^-)p (koris) and signi.
fies "constriction or condensation;" in Chaldea, i^it^Hp (^o'*-
yza,) the Greek term without the alteration of a letter, and is
strictly cold, '•'' algor, or /rigrts." It is precisely the same in
Syriac, koryza, and is employed in this exact sense in the
Syriac New Testament, John xviii. 18, and various other pas-
sages; while in Arabic we meet with it under the Hebrew
form, koris, embracing the double idea of cold and condensa-
tion, or infarction, and consequently including both the cause
and effect.

The subject is interesting, and might be pursued to a great
extent. Oth^r examples will occur in the ensuing pages ; but
enough has, perhaps, been said, to show the importance of con-
necting the science of the healing art with a general study of
the Oriental tongues, and of exciting the young pathologist to
a cultivation of Arabian literature, in conjunction with the medi-
cal learning of Greece and Rome.

IV. There is yet another, and a very prominent feature, of ■■
the present work, which it is necessary to notice before we
close, and which it is hoped will meet with the reader's appro-
bation. In order to afford relief to the dryness of technical de-
finitions, and verbal criticism, the author has digested his notes
into a running commentary, which he has endeavoured (o ren-
der replete with interesting cases, valuable hints or remarks,
and singular physiological facts, gleaned from a pretty exten-
sive perusal of the most approved authorities, collectiye or.in-

IXXX PRELIMINARY DISSERTATION.,

dividual, ancient or modern; occasionally interwoven with
similar illustrations, as they have occurred to the writer in his
own private walk and intercourse of lite.

There has, of late years, been an unnecessary degree of
scepticism thrown over several of the public Journals, or
Ephemerides, to which he has occasionally referred, in conse-
quence of their containing much of the marvellous, and reposing
on the sole authority of the individual, by whom the case or
article is related. It should be remembered, however, that
several of these collectanea were established for the express
purpose of communicating singular and extraordinary facts or
occurrences in natural history or physiology, and of confining
themselves to such cases. It is true, that they are for the most
part published upon the responsibility of the writer alone ; but
it is upon the same single credit that by far the greater number
of cases are given which are published in our own day, wheth-
er by individuals, or by collective bodies. Even the Royal
Society, from whom the ensuing pages have, perhaps, chiefly
borrowed, does not, in communicating its transactions to the
public, assume a higher degree of testimony ; and thinks it
prudent, by a special advertisement, prefixed to every half
volume, to caution its readers that its committee do not pretend
" to answer for the certainty of the facts, or propriety of the
reasonings, contained in the several papers, which must still
rest on the credit or judgement of their respective authors."
This, indeed, ever has been, and ever must be, the main ground
of authority, and rational assent ; and on this account, while
the writer has selected from a somewhat extensive range, he
has endeavoured, as far as he has been able, to weigh the
characters and stations of the different individuals from whom
he has quoted, whether as isolated reporters, or members of
scientific academies : though it is highly probable, after all,
that the greater number of the most curious and extraordinary
aberrations from the common laws of health and disease, intro-
duced into the ensuina; commentary, will be found drawn from
well-established scientific miscellanies and transactions of our
own day rather than from those of earlier periods.

There are a few distinguished characters from whom the
author has quoted with peculiar freedom, for 'he express pur-
pose of pointing out the sources to which he has been indebted
for much of the most valuable information he has been able to
acquire upon the subject imme/Jiately before us, and in order
to excite the student to a trial of the same path. These, among
the ancients, are Galen and Celsus 5 and, among the moderns,

PRELIMINARY DISSERTATION. Ixxxl

not to name the nosologists who have already passed in re-
view before us, Hewson, J. Hunter, Cruikshank, Fordyce, and
Baillie.

The student, who has made himself master of Galen and
Celsus, is enriched with all the general information he will ever
stand in need of from the schools of antiquity, antecedently to
the Arabian caliphats. Nothing, however, can be more difter-
ent than their manner, which, indeed, is one cause of the dif-
ferent extent of their labours ; for the field of both is the same,
not only in respect to matter, but nearly so in respect to range.
The Medicina of Celsus is a close practical compendium of the
nosology, therapeutics, and surgery of Greece and Rome dur-
ing his own age, which was probably that of Augu&tus,* for the
most part compared with those of the earlier Greek schools. It
is written with equal elegance and modesty, and is introduced
by a chapter on the laws of health. The works of Galen, who
was physician to Marcus Aurelius, are speculative as well as
practical : they contain a full history of most of the Greek theo-
ries, and attack every one which is in opposition to the doc-
trines and opinions of Hippocrates ; whose system he reviv-
ed, defended, and illustrated with incontrovertible arguments,
consummate learning, and unrivalled ingenuity. His genius
was almost universal, and led him to drink deeply of every
branch of science that adorned his age ; and seems sometimes
to have tempted him to indulge in a redundant and unnecessa-
ry display of learning. Vesalius, with a jealousy unworthy of
himself, accuses him of having studied comparative anatomy
to the neglect of human ; but the charge was triumphantly re-
pelled from passages in his own works as soon as it was ad-
vanced. Being a native of Pergamus, he wrote in the Greek
tongue, but his style is far less elegant than that of Celsus. The
best edition of his works, which is that of Venice of 1625, ex-
tends to seven volumes folio, including a Latin version. A
more valuable present could not be made to the medical pro-
fession than a judicious compendium of these volumes, taking
the terse compressed manner of Celsus as an example upon the
occasion. As the joint Latin version of Linacre and the Ita-
lian interpreters is in far more general use than the original
Greek, the author has preferred it in his quotations for the sake
of an easier reference, excepting in a few instances of verbal

* The biographers of Celsus have usually placed him under the reign of Tibe-
rius; but Bianconi has employed far stronger arguments to show that he flourished
in the Augustan age. Episl. de Celsi JElale.

Ixxxii PRELIMINARY DISSERTATION.

criticism, in which he has thought it right to advert to the
Greek text itself.

Upon the distinguished merit and talents of the illustrious
English writers from whom he has also drawn somewhat large-
ly, and whom he is chiefly anxious to recommend to the indus-
trious student, it is unnecessary to say a word. They are not,
indeed, the fathers of physiology ; but they have furnished us,
in a regular succession of instruction, with far more light, and
far more important discoveries upon the subject, than have
been developed by any train of writers, with the exception of
Baron Haller, since the days of Harvey ; and have taught us
how we may best interweave the principles of the animal eco-
nomy, and some of them those of animal chemistry, with the
practice of the healing art, and render them subservient to the
most important purposes of the profession. The study is still new,
and opens to us a vast uncultivated region : and it is not surpris-
ing, therefore, that its earliest labourers should occasionally
have erred in beating their way through its tangled and untrod-
den track, and especially when indulging in a bolder and more
discursive imagination. But he who, in following the path they
have thus struck out, is most sensible of their errors, must have
studied them with no desirable spirit, if he be not at the same
time, most sensible of their exalted merits, and of the deep
obligations they have conferred, not only on the world of me-
dicine, but on the world of man.

SERIES

OF

CLASSES AND ORDERS.

CLASS I.

CCELUCA.

Diseases of the Digestive Function.

Page.

Order I. Enterica 1

AflFecting the Alimentary Canal.

II. SPLANCHNICA 56

Affecting the Collatitious Viscera.

CLASS IL

PNEUMATICA.

Diseases of the Respiratory Function.

Order I. Fhonica » 70

Affecting the Vocal Avenues.

II. Pneumonica 81

Affecting the Lungs, their Membranes, or Motive Power.

CLASS III.

Hi;MATICA.

Diseases of the Sanguineous Function.
Order I, Pyrectica . , 9§

Fevers.

Jxxxiv SERIES OF CLASSES AND ORDERS.

Page.

II. Phlogotica 113

Inflammations.

III. ExANTHEMATICA 157

Eruptive Fevers.

IV. Dysthetica • 185

Cachexies.

CLASS IV.

NEUROTICA.

Diseases of the Nervous Function.

Order I. Phrenica 219

Affecting the Intellect.

II. iEsTHETIOA 237

Affecting the Sensation.

III. CiNETICA 260

Affecting the Muscles.

IV. Systatica 273

Acting several or all the Sensorial Powers simultaneously.

(

CLASS V.

GENETICA.

Diseases of the Sexual Function. ;

Order I. Cenotica 294

Affecting the Fluids.

II. Orgastica 303

Affecting the Orgasm.

ill. Carpotica ' 31?'

Affecting the Impregnation,

SERIES OF CLASSES AND ORDERS. IxXXV

CLASS VI.

ECCRITICA.

Diseases of the Excernent Function.

Page.

Order I. Mesotica 325

Affecting the Parenchyma.

II. Catotica 336

Affecting Internal Surfaces.

III. AcROTiCA 354

Affecting the External Surface.

CLASS VII.

TYCHICA.

Fortuitous Lesions or Deformities.

Order I. Apalotica 395

Affecting the Soft Parts.

II. Stereotica j^ . 407

Affecting the hard Parts.

III. MORPHIGA ^412

Monstrosities ol Birth.

^

TABLE

OP THE

AFFIXES AND SUFFIXES

THAT CHIEFLY OCCUR IIV THE ENSUING NOMENCLATURE,

With the Senses in which they are used.

AFFIXES.

A («t) Diminution or }oss of quality or power.

Apo, ap, aph . . (am, att, «<}>) . . . . / For the most part iterative, duplicate, or

Cata, cat .... (luiTct., jwt) \ augmented action : but often indeter-
minate.

Dia («'''*) Separation ; secernment ; or secretion.

Dys • . (<r«/c) Morbid state or action generally; empha-

tical, when accompanied with distress
or difficulty.

Ec, ex («5 «|) )

Epi, ep, eph . . (tm, esr, scf.) v. Out of; outwards; over; above.

Hyper {'J^ff) )

En . , (if) Within ; below ; applied to places. Su«

periority ; excess or intensity ; applied
to quantity or quality.

Para (vAfA) Morbid state or action generally ; and

hence synonymous with dys ; except in
a few terms derived from anatomy, in
which it imports apud, "bordering on,"
as in parotitis, paronj'chia.

Peri (""tpO Circuit ; circumfennce.

IxXXviii TABLE OP AFFIXES AND SUFFIXES.

SUFFIXES.

Algia (it^yict) Pajn or ache.

Asmus, osmus, . (xa-f**, eia-f^oc) . • . . ) "

Esmus, ismus . . (tfuo! iruoc) . . . . i ^"'''•^ action, power, or possession gene-

Esis, osis .... ((«f, lr,(^ ...... i ^^^^y ' ^"* mostly very indeterminate.

^^sis (lAo-tt) Cutaneous eruption, unconnected with

fever as its cause.

Itis (/Txc) Organic inflammation.

Kele, cele .... (mikh) Covered protrusion of a soft part.

Odes (anTwj) Like ; a-kin to.

Oma (my-et) External protuberance.

Ptoma (Trrafjut) Naked prolapse of a soft part.

Rhoea Go'*) Preternatural flux of any fluid except

blood.
Rhagia .... Qayta.) Preternatural flux of blood.

liATIN.

jgo Diffusive or migratory action or motion.

Ilia, ula ). , ,. . . . .

,„ . , . > Simple diminutive terminations.

Illans, ularis V

Osus Simple augmentive termination.

NOSOLOGY.

CLASS I.
CCELIACA.

DISEASES OF THE DIGESTIVE FUNCTION.

ORDER I.
ENTERICA.

AFFECTING THE ALIMENTARY CANAL.

Disquiet, or diseased action in some part of the passage for
the reception and detrition of the food.

GENUS I.

O D O N T I A.

Pain or derangement or the teeth or their sockets.

Odontalgia. Sauv.

Class I. Ccbliaca. KciXixxet.) " alvina," from *«</<«, " alvus" " ven-
ter:" and hence the terms cceliac artery, and coeliac passion.

Order I. Enterica. 'Emp«ie«, '"'' intestinalia ;" from evrepov, " intes-
tlnum," " alvus," " viscus."

Gen. I. Odontia. From cSovj, " dens." This word is preferred
to odontiasis, first, because the termination iasis is now generally in-
dicative of diseases of the skin ; and next, because odontiasig has
1

2 NOSOLOGY. [CL. I.-OR. I.

1. DENTiTfOMis. Irritation froiii Cutting the teeth.
Odontiasis. Paul. JEgin.
Odontalgia dentitionis. Sauv.
Odaxismus. ^og.
Ziras. Arab.

been chiefly limited to a single species of the present genus, o. do-
lorosH, or tooth-ache. In the compounds of «3ai;5, odontia is eommon
to the Greek writers, as r^to^ovrtx, &c.

As the jaw-bones of youth are both wider and longer than those of
infancy, it is obvious that the teeth which are cut in the first year
must be incapable of tilling up the bony arch of the fourteenth.
They might indeed have been so contrived as to grow in proportion
to the increased range of the jaw-bones ; but from their being ex-
traneous bodies, this must have been a very complex process, while
the very circumstance of their growth, and the internal change
which must be continually taking place, would expose them to ma-
ny more diseases than they are subject to at present.

A much simpler plan has been devised ; and the teeth of man, as
indeed of most mammals, are composed of two distinct sets, difTering
both in number and structure : the first or smaller set consisting of
ten for each jaw, which are cut between the ninth and twenty-fourth
month after birth, shed between the seventh and fourteenth year,
and from the period of their protrusion called milk-teeth; and the
second, or larger set, consisting of fourteen, fifteen, or sixteen for
each jaw ; for they occasionally vary in number, which are cut pro-
gressively, upon the shedding of the first set, between the seventh
or eighth, and the seventeenth or eighteenth year, and from their
continuing till old age, except in cases of accident or disease, are de-
nominated permanent teeth. The farthest grinder on each side,
however, is seldom cut so early as tlie eighteenth year — generally
after the twentieth, and sometimes not till the thirtieth : on which
account these teeth are denominated dentes sapientice, or teeth of
wisdom.

The rudiments of all the first set, and of four belonging to each
jaw of the second set, are produced in the foetus. These rudiments
consist of minute pulpy substances secreted in the body of the gums,
progressively elongating to form their respective necks and fangs.
They are each surrounded by a peculiar membrane, and a bony pro-
cess which is denominated its alveolus or socket, that shoots up from
the jaw-bone as the tooth advances ; it accompanies its growth, and
at first entirely surrounds it, though it yields in its upper surface as
the tooth, in consequence of the gradual elongation of its fang or
fangs, is forced through and cuts the gum ; and when the first set,
having answered its temporary purpose, has its fangs absorbed, and
the body of each tooth shed or cast out by the gums, the attendant
sockets are equally absorbed, and disappear at the same time.

GE. I.]

NOSOLOjGY.

Zahnen. G.

Dentition. F,

Teething.

tt Lactentium. Cutting the milk or shedding teeth.

C Puerilis. Cutting the second set or permanent teeth.

This wonderful change begins to take place, as already observed,
about the seventh year, at vvbich time we possess far more teeth,
including both the grown and the growing, than at any other period
whatever : for we have in each jaw ten temporary teeth complete,
ten incomplete to succeed them, and the two permanent grinders,
whose stamina were formed during fetal life, maUmg not less than
forty-four in the whole. The permanent teeth have separate sock-
ets of their ow-n, and in consequence of the prolongation of the
jaw-bones, and their augmented breadth to meet this change, do not
lie immediately under the corresponding shedding teeth, nor direct-
ly contribute to the process of shedding, which chielly takes place
in consequence of the absorption of the fangs and sockets of the tem-
porary set, though their ascent contributes in some degree to the
general process.

1. y O. dentitionis, Adultorum — The cutting of these teeth is of-
ten attended with peculiar pain and inconvenience, especially when
the process takes place very late, and consequentl}' after the jaw-
bones have ceased to grow : for we have in this case olten a want of
sufficient room, and, in the upper jaw, the tooth on each side i* fre-
quently obliged to grow backward, in which position it sometimes
presses on the anterior edge of the coronoid process in shutting the
mouth, and consequently gives considerable pain. When the same
fact takes place in the lower jaw, some part of the tooth continues
to lie hid under that process, and covered by the soft parts, which
are always liable to be squeezed between the new tooth and the cor-
responding one in the upper jaw. Nothing but a free opening will
ever suffice in this case, nor even this always ; for at times the evil
can only be cured by removing the tooth itself.

1. S O. dentitionis, Senilium. Occasionally reproduced as late as
at the age of ninety or a hundred. At 92 Ysabern, Journ. de Med.
torn. XXV. p. 316.— At 100iVi/^5e/i,Ephem. Erudit. Ann. 1666, p. 175.
—At 120 Ephem. A'at. Cur. Dec. ii. Ann. iii. Obs. 1.5-

For the most part, the teeth shoot forth irregularly, and few in
namber, so as to be of little benefit, and sometimes more injurious
than useful, by preventing the approximation of the callous gums,
which till now had been emploj^ed as a substitute for the teeth. In
one instance, though only in one, Mr. J. Hunter informs us, that he
was witness to the reproduction of a complete set in both jaws; and
he supposes that in all these cases a new alveolar process is formed
as in the preceding sets. " From this circumstance," says he, " and
another that sometimes happens to women at this age, it would an-

4 NOSOLOGY. [CL. I.-OR. 1.

y Adultorum. Cutting the adult or wise teeth.

5 Senilium. Cutting teeth in advanced life, or old age.

pear that there is some effort in nature to renew the body at that
period."

He alludes to a return of menstruation : but there are other facts,
and of perhaps a still more singular kind, that point to the same
conclusion. The author once attended a lady who cut several strag-
gling teeth at the age of seventy-four, and at the same time recov-
ered her sight so completely as to throw away her spectacles, which
she had made use of for twenty years, and to be able to read with
ease the smallest print of the newspapers. In another case that oc-
curred to him, a lady of seventy six cut two molares, and at the
same time completely recovered her hearing, after having for some
years been so deaf as to be obliged to feel the clapper of a small
hand-bell which she always kept by her on a table in order to know
whether she made it ring.

One of the most singular instances on record is that given by Dr.
Slare in the Phil. Trans, vol xxvii. 1713, as it occurred to his fa-
ther. At the age of seventy-five he renewed an incisor lost twenty-
five years before ; at seventy-seven, he renewed another incisor to
supply a similar vacancy ; at eighty, all his teeth were hereby ren-
dered perfect ; at eighty-two, they all dropped out successively ;
two years afterwards they were all successively renewed : so that
at eighty-five he had an entire new set. His hair simultaneously
changed from a white to a dark hue, and his constitution seemed
somewhat more healthy and vigorous. He died suddenly at ninety-
nine or a hundred.

2. Odontia dolorosa. The varieties are abridged from CuUen, or
rather from Sauvages, from whom CuUen has copied them. In the
earlier editions of Cullen's Nosology, odontia dolorosa (odontalgia
as he terms it) is arranged as a species of rheumatism, after Hoffman.
In the fourth and succeeding editions it is raised to the rank of a dis-
tinct genus, and placed (xxii) between arthrodynia and podagra.
The Anglo-Saxon name for this affection was toth-ece.

There may possibly be other varieties than are here offered. Ev-
ery tooth has an internal cavity, which commences at the point of
its fang, and enlarges as it ascends into its body. This cavity is not
ceiluliir, but smooth in its surface ; it contains no marrow, but ap-
pears to be filled with blood-vessels, which are doubtless accompa-
nied with nerves, which must necessarily be derived from the second
and third brunches of the fifth pair, though they have never been
distmctly triiced. In the interior of this cavity the teeth appear to
be peculiarly sensible, and hence direct or indirect exposure to the
oxtf.'rnni air, or in other words a carious aperture, or a current of
sharp -.v.r williout such aperture, (lor f ho a.r «eems in many instances
to act through the substance of a sound tooth), will be sufficient to

GE. I.] NOSOLOGY.

2. DOLOROSA. Acute pain in the teeth or their sockets.
Odontalgia. Hoffm. Lin. Vog, Cull.

produce acute pain, and is in fact the common cause of tooth-ach :
on which account the readiest modes of cure consist in stopping up
the aperture with metal or some other substance, defending the
tooth from the access of cold, or destroying the nerve by. caustics or
cauteries through the aperture itself

Perhaps the pain called scorbutic maybe regarded as an example
of the sympathetic variety : that from gout is for the most part a real
transfer of action, the organ previously affected being generally at
ease, or nearly so, during its continuation.

For the caries of perfect teeth it is not easy to account. Out of
the body they are indestructible, excepting by very powerful chem-
ical agents ; and yet, in the judgment of many physiologists, they
are nearly in the same state in the body as out ot it ; being extra-
neous substances formed complete at first, without vascularity,
growth, or internal action, and even destitute of absorbents. Such
at least was the opinion of Mr. J. Hunter when composing his "• Na-
tural History of the Human Teeth," an opinion drawn from the im-
possibility of injecting them — the perfection in which they are pro-
duced at first, and their retaining their natural colour after so long
a use of madder as a food, that all the other bones of the body have
become thoroughly tinged with it. " But they have most certain-
ly," says he, " a living principle, by which means they make part of
the body, and are capable of uniting with any part of a living bo-
dy ; and it is to be observed, that affections of the whole body have
less influence upon the teeth than upon any other part of the body.
Thus in children affected with the rickets, the teeth grow equally
well as in health, though all the other bones are much atlected ; and
hence their teeth being of a larger size in proportion to the other
parts, their mouths are protuberant."

Admitting the soundness of these experiments, and the accuracy
of this reasoning, it seems impossible that the teeth, when once
perfectly produced in the gums, should ever decay : for no action of
the living principle can occasion a secretion of those chemical
agents which would alone, in such case, be capable of destroying
them. It is probabie therefore that this reasoning is erroneous, and
that the teeth are vascular, though the art of injection is incapable
of tracing the vascular structure, and the colouring particles of
madder-root are not sufficiently attenuate to enter their vessels.
Mr. Hunter himself, indeed, appears to speak with some degree of
hesitation in the treatise before us ; and in his subsequent tieaase
"On the Diseases of feeth," otiers observations that seem lo ^how
he had at that time embraced a different opinion. In the tirst essay,
indecvl, he allows that ''the fangs of teeth are i able to swellings,
seemingly of the spina ventosa kind, like other bones ;" but he im-

6 NOSOLOGY. , [CL. l.-OR. I.

Pentium dolor. Cds. vi. 9.

Zahn-peiii. G.
Mai de dents. F.
Tooth-ache.

mediately adds, that " there may be a deception here, for the swel-
ling may be an oriafinai formation." Yet in the second essay, he
treats of this swelling as one of the diseases to which the teeth are
perpetually liable ; he regards the teeth as subject to the common
tintlammation of other bones, and, like other bones, evincing at times
great sensibility through the entire substance of the organ, as well
as in the central cavity itself. Nor is it quite certain that the body
of a tooth does not occasionally enlarge as well as its fangs ; for no-
thing is more common than for the space produced by extracting
one of the grinders of a healthy adult to be filled up by an approx-
imation of the two adjoining teeth. Mr. Hunter, indeed, endeavours
to account for this, by supposing that each of these teeth has been
pressed into the vacancy by the teeth behind them, in consequence
of their want of a proper support in this direction; but in such case
there must be some vacuity discoverable between themselves and
the teeth which have thus urged them forward. In various cases,
the author has never been able to trace any such vacuity whatever;
and has a decisive example to the contrary in the state of his own
teeth : for having, when a boy of twelve years old, had the second of
the bicuspidati extracted, the vacancy thereby produced has been so
completely filled up by the enlargement of the adjoining teeth, that
these teeth closely touch, and he is only able to introduce a fine
probe between them at the neck, or lowest and narrowest part ;
while he can introduce nothing between any of the other teeth,
which have in no respect given way or separated from each other.
There is probably, therefore, some internal action continually
taking place, though we are not able to trace it very evidently.
And it is probable, also, that a caries of the teeth is occasionally
produced by some internal cause operating upon and vitiating this
action, though there can be no doubt that the chief causes are ex-
ternal. We have already noticed exposure to currents of cold air,
and the medical practitioners of Germany and the north appeal to
the opposite extreme, of the habitual use of hot aliments as a still
more general and mischievous source of the same evil. In the
Swedish Amoanitates Jlcadeinicoi^ Vol. Vll. art. 136, we have an ela-
borate examination of this subject by M. Ribe, who tells us, among
other things, that" man is the only animal accustomed to hot foods,
and almost the only animal affected with carious teeth." Whence
the author takes occasion to condemn, in an especial manner, the
custom of drinking hot tea and coffee. And, in accordance with this
remark and recommendation, M. Till^us, another celebrated writer
in the same interesting journal, tells us from Kalm, in his paper en-

GE. t.] NOSOLOGY. 7

« Cariosa. Carious, or from decay.
C Catarrhalis. From cold.

y Nervorum. Chiefly or altogether confined to the nerves
of the sockets or jawr-bone, and not relieved by ex-
tracting the suspected teeth. Hunter on Teeth, p.
190.
d Sympathetica. From sympathy: as that of pregnancy,
or irritating sordes in the stomach.
Found also, occasionally, as a symptom, in scurvy
(porphyra). erratic gout, and hysteric diathesis.
3. sTUPORis. Tingling pain in the teeth from stridulous sounds,
vellication, or acrid substances.
• Haemodia, («/,«»§««). Jirisiot.

titled Potus Thfce, that the Indians of North America knew nothing
of the inconvenience of carious teeth or debilitated stomachs, till
tea was introduced among them. There can be no question that
the two extremes of heat and cold must be greatly, perhaps equal-
ly injurious to the teeth ; and as little that the inhabitants of high
northern latitudes must suffer more than others from the use of hot
aliments in consequence of the greater coldness of their atmosphe-
rical temperature.

By whatever means, however, a decay or caries of the teeth may
be produced, it appears to operate in three different ways ; some-
times commencing in the internal cavity, and working its path out-
ward ; sometimes outward, and working its path within ; and some-
times by a wasting of the enamel, and consequent denudation of the
bony part. The first is the least common affection, and is discover-
able by the appearance of the internal blackness through the ex-
ternal shell ; the third is more common than the first, and the se-
cond the most frequent of the whole ; evmcing, at its commence-
ment, the appearance of an opake white spot through the enamel,
which gradually crumbles away about the spot, and thus discloses
that part of the body of the tooth which forms the original seat of
the disease, and which, by its continuance, converts the early spot
into a hole, and at length destroys it altogether, or at least down to
its neck, unless the pain produced by its progress compel the patient
to have it extracted before the disease advances thus far.

3. Odontia stuporis. Darwin Zoonom. Sect. xvi. 10, and Class iv,
i. 2. 3. has obs^erved, that this unpleasant affection is at times pro-
duced by imagination alone. At the time of writing this, the author
has just left a very intelligent friend, by whom he was consulted
upon a case of spongy and highly irritable gums (gen. i. T. «.), and
who observed, that just before the author saw him, he thought he
should have gone mad upon hearing a woman cry buUaces for sale :

8 NOSOLOGY. [CL. I.~OR. I.

Odontalgia haemodia. Sauv.

Doior dentium a stridore. Darw,

Zahne-stumpf. G,

Agacement des dents. F.

Tooth-edge.

a A Stridore. From grating sounds.

C Ab acritudine. From vellication or acrid substances.

4. DEFORMis. Deformity of the teeth from error of shape, po-

sition, or number.

5. EDENTULA. Loss or Want of teeth.

Nodosia {vahrtx). Auct. Grcec*
Nefrendis. Vog,
Tooihlessness.

it gave him a tooth-edge, that, to use his own terms, convulsed all
his muscles, and seemed to run through his hrain.

4. Odontia deformis. This species was called by the Greeks
chauliodos {x,»vXto^oi), as was also the person who was thus disfigur-
ed. Jrist. de Part. an. iii. 1. Oppian. de Venat. 1. vii.

See Hunter, p. 115, 199, for examples of a double row of teeth :
as also Bloch^ Medicinische Bemerkungen, p. 19. Triple row, Aean-
der, Physic, Part II. Numerous and confused rows, Eph. JVat. Cur.
Dec. I. ann. iii. p. 566. ann. vii. viii. obs. 101.

5. Odontia edentula. In the varieties of this species the affection
seldom extends to all the teeth except in the case of old age. In
the tirst, or that from constitutional defect, a few only in one or
both jaws are left unprovided for ; while sometimes an effort to this
purpose is commenced, but not carried to perfection. " In the head
of a young subject which 1 examined,'' says Mr. J. Hunter, " I
found that the two first incisor teeth in the upper jaw had not cut
the gum ; nor had they any root or fang, excepting so much as was
necessary to fastea them to the gum on their upper surface ; and on
examining the jaw, I found there was no alveolar process nor sock-
ets m that part." Nat. Hist, of the Human Teeth, p. 8.

7. Odontia excrescens. This is a common symptom of the true
scurvy ; but it should not be confounded with it, as it is sometimes
an attendant upon other diseases, and sometimes an idiopathic affec-
tion. " I have often," says Mr. J. Hunter, "seen the same appear-
ances in children evidently of a scrofulous habit; and have also sus-
pected them in grown people. They likewise frequently appear in
persons who are in all other respects perfectly welV Diseases of the
Teeth, &c. ch. iii.

Gen. II. Ptvalismus. 5rTi»«A«rjM.o?, or 7nvi>^i<rfA0i, from vrvu, " ex-
spuo," " excreo." The sympathetic variety of this species is so
common as to become proverbial. It is most obvious, however, in
those animals whose salivary glands are peculiarly irritable, and

GE. I.] NOSOLOGY. 9

tt Peculiaris. From constitutional defect.
Q A vi extrinseca. From external violence.
y a carie. From decay.
S Senilium. From old age.

6. iNCRUSTANS. Teeth incrusted with extraneous matter. 7a?*-

tar of the teeth. Hunter, p. 192.

Concreted by it into one mass. Eustach. Tr. de Dent,
cap. 2.

7. EXCRESCENS. The substance of the surrounding gums excre-

scent.
Epulis (tTrevXti). Paul. Mgin. iii. 26.
« Spongiosa. Fungous or spungy gums.

Scurvy of the gums, vulgarly so called. J. Hunter, p. 1 84.
C Extuberans. With distinct extuberances on the sur-
face.
Epulis. Heister. Chir. tom. i. p. ii. c. 85.
Sarcoma epulis. Sauv.

Sometimes softer and fleshy. J. Hunt. p. 169; and
sometimes thicker and callous. Id. p. 188. Produced
by vermicles. Act. Erudit. Lijos. 1715, p. 410. 1719,
p. 12.

consequently soon excited to increased action ; as the domestic dog,
which from this circumstance is almost always slavering ; and in
which this secretion seems to answer the purpose of insensible per-
spiration in other quadrupeds, for the domestic dog is not known to
have any such discharge, and never sweats under the severest ex-
ercise. Munro^Com^. Anat. This curious fact has not been suffi-
ciently attended to in studying comparative physiology: for it seems
capable of giving us a glance at many of the most singular diseases
by which the dog is peculiarly characterised.

As a critical discharge, salivation is for the most part salutary,
and ofted terminates the disease that excites it. This is frequentlv
the case in fevers, and the following instance is perhaps worth re-
lating. A lady aged twenty-four, and of a delicate constitution, was
attacked with a typhus in the spring of 1788, under which she gra-
dually drooped for nearly three weeks. The author thought her
in great danger; but ou the twentieth day a sudden and copious
ptyalisra supervened, that evidently afforded her considerable relief.
This continued for upwards of a week, the daily secretion being
never less than a pint, and tvvice not less than a pint and a quarter.
Yet, instead of adding to her debility, it appeared to give fresh
vigour to the system : the digestive function resumed its office,- she
daily improved in strength, and on its cessation at the above period,
was in a state of convalescence.
2

10 NOSOLOGY. [CL. I.-OR. I.

G^ENUS II.

PTYALISMUS.

Involuntary flow of saliva from the mouth.
Ptyalismus (srTua^ir^o?). Hippocr. Coac.
Anabexis (<t»«S»i^<s). Gal.
1. AcuTus. Increased secretion of saliva from increased action
of the salivary glands.
Salivatio callida. Darw. i. i. 2. 6.
Epiphora ptyalismus. Young.
Speichel-fluss. G.
Salivation. F.
Salivation,
et Hydrargyratus. Produced by the use of mercurial pre-
parations.
Ptyalismus mercurialis. Heins. Sauv.
C Sympatheticus. Produced by the sight, smell, or thought
of agreeable food.
Salivae flnxus cibo viso. Darw. iv. i. 2. 6.
Mouth-wa iering.

We have numerous histories in which it has proved equally ser-
viceable about the acme of small-pox ; and the fluid of dropsies is
said to have been not unfrequently carried off by the same channel.
In the Medical Observations and Inquiries, ni. 241, there is a singu-
lar case of an obstinate vomiting of five months standmg being re-
lieved, npon a return of a salivation, which for this period had
ceased. But perhaps one of the most extraordinary instances to be
met with is related by Dr. Huxham, in Phil. Trans, for 1724, Vol.
XXXIII. The patient was a man aged forty, of a spare, bilious ha-
bit, who had an attack of jaundice, followed by a paroxysm of colic,
this last being produced by drinking too freely of cider. Among
other medicines was given a bolus, containing a scruple of jalap,
eight grains of calomel, and a grain of opium. Copious dejections
followed, and a few hours afterwards the patient complained of pain
and swelling in the fauces, spat up a little thick, brown saliva,
which was soon considerably increased in quantity, of" a deep co-
lour, resemi)!ing greenish bile, though somewhat thinner. This
flux of green and bilious saliva- continued lor about Ibrty hours,
during which time the quantity discharged amounted to two sexta-
rii, or four pints. The colour oi" the saliva then changed to yellow,
like a solution of gamboge, with an increase rather than a diminu-
tion of the quantity. It continued of this colour for the space of

liE. II.] NOSOLOGY. li

y Mellitus. Accompanied with a sweet or mucilaginous
taste.
Apocenosis, ptyalismus, mellitus. Parr.
Sweet-spittle.

■ See for examples Act. Hafn. iv. obs. 72. Schurig, Sialo-
graphia. Found also, occasionally, as a symptom in den-
tition, and as a sequel or crisis of various other aliections.

2. cHRONicus. Increased secretion of saliva from debililatcd

habit; and relaxation of the salivary glands.
Ptyalismus a laxitate. Cheyne. Sauv.
Ptyalismus asthenicus. Parr.
Ptyalismus idiopathicus. Crickt.

" Si quis ptyalismus idiopathicus sit, pro eo hnbcre vel-
lem." Cull. J^osol. gen. cxx. See Ephem. Nat. Cur. Dec.
II. ann. vii. obs. 5.

3. iNERS. Involuntary flov/ of saliva from a sluggishness of de-

glutition without increased secretion.
Geiffern. G.
Bave. F.

Drivelling. Slavering.

<* Infantilis. Of infancy: independently of dentition,
f Senilis. Of old age.
y Moriae. Of dotards or ideots.

forty hours more, after which it gradually became pellucid, and the
salivation ceased as suddenly as it came on. During the flow of the
saliva, the teeth and fauces were as green as if they had been stain-
ed with verdigris, and the teeth retained the same colour for a fort-
night after the ptyalism had ceased. The patient had a few years
before been suddenly attacked by a spontaneous salivation, so exces-
sive as to endanger his life. In the present instance, therefore, it is
probable that the dose of calomel co-operated with the peculiarity
of the constitution in exciting the discharge : but whatever was ils
cause, it proved critical both of the jaundice and the colic ; for, from
the moment it took place, the pain of the bowels ceased, and the
greenish colour of the skin began to subside, the urine being at the
same time secreted more abundantly, and of a blackish hue.

The secretion of sweet or mawkish saliva is not only for the most
part free, but accompanied with nausea, and other symptoms of in-
digestion : and is probably what Sauvages intends by his lirst species,
p. nauseosus, or a saburra nidorosa. It is relieved by magnesia and
other absorbents ; but will often only yield to an emetic, followed
by warm stomachics. The author has not found acids of more than
palliative service, and has sometimes thought the complaint worse
'for their exhibition

12 NOSOLOGY. [CL. T.-OR. I.

GENUS III.
DYSPHAGIA.

Pain or obstruction in swallowing without inflammation, and
mostly witheut impeded respiration.
Dysphagia, Sauv. Cull, Sag. Plouquet.
Ocatoposis. Vog.
(Esophagismus. Vog.

1. coNSTRicTA. Difficulty of swallowing from permanent con-

traction of the oesophagus.
Dysphagia oesophagea. Sauv.

The contraction may be produced by ossification, ex-
crescences, scirrhous, or calculous concretions about the
palate, &c.

2. ATONicA. Difficulty of swallowing from debility of the mus-

cles of deglutition.

Gen. III. Dysphagia. From ^uj, male, and (payw, edo, glutio. It is
sing-ular that so few of the nosologists should have followed Sauva-
ges in making this a distinct genus ; since dysphagia is as much en-
titled to such a distinction as dysphonia, or paraphonia, as it occurs
in CuUen. Sauvages has unquestionably, as in several other genera,
introduced species that belong elsewhere, and which he is again
obliged to notice in other places ; but the species now offered can,
perhaps, be no where so well arranged as in their present situation,
and the generic character is sufficiently marked. In Parr, dyspha-
gia is arranged as a species : but it is uncertain what he intended it
to import ; for though he has placed it in his nosological catalogue,
he has no where explained it, and has altogether forgotten the word
in his general alphabet. In this catalogue it occurs under a genus
which he has named constrictoria, and which, with singular violence,
includes along with it obstipalio and polypus.

1. Dysphagia constricta. See Bonet. Sepulcr. obs. 10. Kriiger
Journ. de Med. Jul. 1765. Heister. Anat. de (Esophago. Sauv. in
loc. Mem. Med. Soc. Lond. II. 177. See especially, Edin. Med.
Essays., Vol. II. 4th edit, in which are two interesting cases of scirr-
hus in the oesophagus; one accompanied with a hard glandiform ex-
crescence, extending from the middle of the canal to the upper
orifice of the stomach, and so closely filling it that a probe could be
scarcely thrust down.

The causes are very numerous: the haltit of drinking very hot
fluids, as tea or coffee, has frequently produced it. It has occasion-
ally been induced by the datura stramonium. See Eph. JVai. Cur.

GE. m.] NOSOLOGY. 13

Dysphagia paralytica. Sauv,
Asthenia deglutitionis. Young.

3. GLOBOSA. Difficulty of swallowing from wind in the stomach

spasmodically compressed into the feeling of
a ball, ascending into the oesophagus, and pro-
ducing a sense of strangulation.

Dysphagia hysterica. Sauv.

Angone. Fog.

Globus hystericus. Darw. i. iii. 1.7.

Orthoprioea hysterica. Sauv.

J\''prvous Quinsey. Heberden.

4. uvuLosA, Swallowing obstructed or troublesome from re-

laxation and enlargement of the uvula.
Hypostaphyle. Sauv. Sag.
Prolapsus uvulae. Parr.
(Edema uvulae. Gorter.
Productio uvulae a pituita. Heister.
Chute de la luette.' F.

5. LiNGUosA. Swallowing obstructed, or troublesome from pro-

trusion or magnitude of the tongue.
Glossocele. Gaubii Pathol.
Paraglosse. Sauv. Vog. Sag.

a. Exertoria. Tongue extended from the mouth, often with
enlargement of the substance.

Paraglosse exertoria. Sauv.

Linguae exertio. Gorter. Syst. Pract. Med.

Prolapsus linguae. Parr.

Stecker-zunge. G.

Sortie de la langue. F.

JLolling-tongue,

Dec. III. an. ii. Moregenerally by ulcers, which usually take place
at the upper or lower extremity of the oesophagus. Sometimes by
a hard thickening of the coats of the cesophagus, similar to what
constitutes a scirrhus in a glandular organ. Baillie, Morb. Anat.
Fasc. III. PI. 3. 4.

In one instance of indurated stricture of the upper part of the
oesophagus, the author knew a lady supported for twenty years by
food passed through a silver canula into the stomach.

3. Dysphagia globosa. This is by no means a mere symptom of
hysteria, as is often supposed ; for it as frequently occurs' under the
influence of various passions, as grief, fear, and anger ; and is a fre-
quent attendant upon the hypochondriacal diathesis. It is, however,
for the most part a sympathetic affection, concatenating with (he
state of the stomach.

14 NOSOLOGY. [CL. I.-OR. I.

See a singular case in Bonet, Sepulchr. Lib. I. Sect. xxi.
obs. 27.
C Ranula. Intumescence of the salivary glands or ducts.
Empbragma salivare. Young,
Frog-tongue.

The species found also occasionally as a symptom in
bronchocele, enlargements of the thymus, and other cau-
ses of external pressure.

GENUS IV.

DIPSOSIS.

The desire for drinking excessive or impaired.
Morbid thirst.

1. AVENs. Constant desire of drinking; with a sense of dry-

ness in the mouth and throat.
Polydipsia. Sauv. Linn. Vog. Sag. Gull.
Sitis morbosa. Bond. Sepulcr. torn. ii.
Grossen durst. G.
Soif excessive. F.

Two hundred pints of wine, and the same quantity of
water drunk daily. Eph. Nat. Cur. cent. vii. obs. 84. —
Eighty measures of liquid daily. Binninger Act. Helvet.
vii. n. 16.

Chiefly a sympathetic aflfection, or symptom of some
other complaint.

2. EXPERS. Constant want of tliirst.

Adipsia. Sauv. Linn. Vog, Sag. Cull.

Gen. IV. DiPSosis. From ^i^aai-a^ " sitio :" and hence the com-
pounds so common in medical nosology, adipsia, polydipsia, phobo-
dipsia, the last being a synonym of hydrophobia. Sauvages relates
two cases of patients in whom it formed an original disease : the one
a learned and excellent member of the academy of Toulouse, who
never thirsted, and passed whole months without drinking in the
hottest part of the summer. The other a woman who for forty
days abstained altogether from drinking, not having had the smallest
desire; and who was nevertheless of a warm and irascible tempera-
ment. Tom. i. p. 770. — See another case that continued for some
years, in the Ephem. JVat. Cur. Cent. v. and vi. obs. 30.

GE. IT.] NOSOLOGY. 15

Mangel-durst. G,
Manquement de soif. F.
Like the last, often symptomatic.

GENUS V.

LIMOSIS.

The appetite for food impaired, excessive or depraved*
Dyspepsia. Cull. Cricht. Young.
Stomach-disease. Cricht,
Morbid appetite.

Gen. V. LiMosis. From Xtfco?, " fames," " esuries," a root as well
known to medical students as the preceding. This genus must ne-
cessarily be of very extensive range and complication, since the sto-
mach, in the language of Mr. J. Hunter, may fairly be contemplated
as the "seat of universal sympathy," (Anim. Econ. p. 138); or, as
he expresses it more at large in p. 132 of the same work, " the sto-
mach sympathizes with every part of an animal, and every part
sympathizes with the stomach."

Nothing can more fully show the necessity of some common radi-
cal to express the idea of hunger, and its relations in a medical
sense, than the multiplicity and even confusion of terms which have
been employed for this purpose by different medical writers. 1
have noticed this subject at some length in the Introductory Disser-
tation, and shall here therefore only remark, that almost every pri-
mitive and compound the Greek tongue can afford has been had
recourse to for this purpose : as Xt^«i, ^*ya, o§'l'«5 Qimus, phago^
orexis) ; hence bulimia, boulimus, boulimiasis, paiulimus, from limus;
phaga3na, phagedaena, and addephagia, from phago ; and cynoresia
and lycorexia, from orexis. For the sake of simplicity and ease to
the student, the author has contined himself to the first of these.

The present genus, in the extent of its range, runs nearly paral-
lel with the dyspepsia of Dr. Cullen ; including, however, I. avens or
bulimia, I. expers or anorexia, and pica, which the latter does not ;
though it is less comprehensive than the dyspepsia of Dr. Young,
which not only includes all these, but adipsia and polydipsia, and
even hypochondriasis and chlorosis.

It is not from a desire of differing from writers of such high and
deserved reputation that the author has not adopted dyspepsia in the
present place, but because it appears to be more appropriate as a
specific than as a generic appellation in the sense of what is usually

16 NOSOLOGY. [CL. l.-OR. I-

1. AVENS. Insatiable craving for food.
Bulimia. Saw. Sag. Cull. Cricht.
Bulimus. Plouqiiet.
Addephagia. Cynorexia. Fo^.
Phagaena. Phagedsena. Ccel. Aurel. Galen, lib. iii. Com.

in Lib. Epidem. Aph. 7.
Nehem. Arab.

Fress-sucht. Hundes-hunger. G.
Faim canine. F.
Canine Appetite.
a Syncoptica. From a feeling of faintness and inanition.
C Helluonum. From habitual indulgeAce in large and fre-
quent meals.

understood by the term indigestion, and nearly parallel to the limited
meaning assigned to it by Vogel, who, perhaps, first introduced it into
methodical nosology. The reader will therefore find it employed
in this sense in spec. 7 of the present genus.

l.«. L. avens, Syncoptica. In the Phil. Trans. Vol. xliii. 1745, is
a sing^ular case related by Dr. Mortimer, of a boy twelve years old,
who from a feeling of inanition had so strong a craving, that he
would gnaw his own flesh when not supplied with food. When
awake, he was constantly devouring, though whatever he swallowed
was soon afterwards rejected. The food given him consisted of
bread, meat, beer, milk, water, butter, cheese, sugar, treacle, pud-
dings, pies, fruits, broth, potatoes; and of these he swallowed in six
successive days, 384 lbs. 2 oz. avoirdupois, being 64lbs. a day on an
average. The disease continued for a year.

Occasionally produced by worms. See a curious case of Dr. Bur-
roughs, Phil. Trans, xxii. 1700; in which the patient from his af-
fection was rendered capable of devouring an ordinary leg of mutton
at a meal for several days together, and fed greedily also on sow-
thistles and other coarse plants.

2. ec. L. expers Pathematica. This is chiefly produced by severe
grief, terror, ardent desire of obtaining an object of pursuit, or reli-
gious enthusiasm. Of the first we have an interesting case by Dr.
Eccles, in the Edinburgh Medical Essays for 1720, of a young lady
about sixteen years of age, who, in consequence of the sudden death of
an indulgent father, was thrown into a state of tetanus or rigidity of all
the muscles of the body, and especially of those ofdeglutition, accom-
panied with a total loss of desire for food, as well as incapacity of swal-
lowing it, for two long and distinct periods of time : in the first in-
stance for thirty-four, and in the second, which occurred shortly af-
terwards, for fifty-four days ; "all which time (observes the writer)
of her first and second fastings she declared she had no sense of hun-
ger or thirst; and when they were over, she had not lost much of

GE. v.] NOSOLOGV. 17

Fress-lust. G.

Gourmandise. F.

Gluttony.
y Exhaustorum. From exhaustion, as the consequence of

• hard exercise, fevers, or excessive discharges.

Bulimia esurigo. Sauv,

Fressenkeit. G.

Voracite. F.

Voracity.
2. EXPERS. Loss or want of appetite without any other appa-
rent affection of the stomach.

Anorexia. Sauv. Linn. Vog. Sag. Cull.
Sauvages has thirteen species, which would here rank as
varieties, but which, as Cullen justly observes, belong rather to
the genus (in the present system, species) of dyspepsy. The
following have perhaps a fair claim to be noticed.

her flesh." Sauvages alludes to a similar effect produced by re-
ligious mania, and nymphomania. Nosol. ii. p. 805. Asthenia absti-
nentium.

2. Z. L. expers Protracta. As gluttony, or a desire to be perpe-
tually eating, may be acquired by habit, so may fasting. See Darw.
Esuris I. 2. 4. In this metropolis the idle always eat more frequent
meals than the busy To what extent progressive habit might enable
man to protract fasting without inconvenience or disease, has never
perhaps been fairly tried : but the appetite of hunger seems, from
various cases, almost as capable of being triumphed over as other
appetites, and the body of being nourished by a very trifling quanti-
ty of food, and for many weeks, perhaps months, even by water
alone. See Marcardier in Journal de Medicine, tom. xxxiii. Schenck,
lib. iii. obs. 39. Waldschmid, Dissertatio de his qui diu vivunt sine
ahmento. Kil. 1711.

One of the best known, and best marked examples in our own day,
is that of Ann Moore, of Tutbury. This woman has indeed been suf-
ficiently ascertained to be a gross impostor, in pretending to be able to
live "without any food whatever : but she seems, from long habit, to
have lost all pleasurable desire for food, and to be capable of sub-
sisting upon very simple liquids alone. She was at first induced to
this habit by an extreme difficulty of deglutition ; and she at length
carried the habit so far as, by deception, easily to excite a general
belief that she never swallowed any thing either liquid or solid.
The intelligent committee, who so laudably formed themselves into
a watch to determine the state of the fact, by a constant attendance
upon her person for a month, have sufficiently proved that she
could not live for ten days without swallowing some portion of liquid.
In their report they tell us, that " on the eighth day she was ex-
3

J 8 NOSOLOGY. [CL. I.-OR. 1.

« Defessorum. From too great fatigue, or the expectation

being worn out by delay.
C Pathematica. From violent passion or other absorption of
the mind.
Asthenia abstinentium. Sauv.
y Protracta. Enabling the system to sustain almost total
abstinence for a long and indefinite time without faint-
ness.
Anorexia mirabilis. Sauv>
Inedia. Jejunium. Plouqiief.
Long fasting.

ceeding-ly distressed," her pulse had increased till it had amounted to
a hundred and forty-five strokes in a minute : and " so far was she re-
duced on the ninth day, that she became in danger of expiring ;"
while a few hours afterwards, when she was compelled to confess
the impostiire she had practised, "the pulse at one wrist had en-
tirely ceased, and the other seemed drawn to a thread." Yet " on
the whole," say the committee, " though this woman is a base im-
postor vvith respect to her pretence of total abstinence from all food
whatever, liquid or solid, yet she can^ perhaps, endure the privation of
solid food longer than any other person. It is thought by those best
acquainted with her, that she existed on a mere trifle, and that from
hence came the temptation to say that she did not take any thing.
If therefore, any of her friends could have conveyed a bottle of water to
her, unseen by the watch, and she coidd have occasionally drunk out of
it, little doubt is entertained that she would have gone through the month^s
trial with credit. The daughter says, that her mother''s principal food
is tea, and there is reason to believe this to be true.'''' — Full Exposure of
Jinn Moore, the pretended fasting woman of Tutbury.

Hildanas and Mailer have collected numerous instances of complete
fasting, for very long periods of time, in some instances for not less
than sixteen years, but most of them are too loosely recorded to be re-
lied upon. There are other cases of thiskind. however, that seem
entitled to more attention. See Willan, Medical Commun. li. 113.
where life was supported sixty days on water with a little orange
juice. Dr. Eccles's case, as given above, v.. 2. «: and the case of
MargaretXower (Phil. Trans. iG81), as stated in the ensuing note
on colica slipata y, who for four months was ordered to desist from
food of every kind, solid as well as liquid, in consequence of the
whole she took, and even the clysters given her, being instantly vo-
mited up.

Four men were preserved in a mine, from which, in consequence
of an accident, they were incapable of being extricated for twenty-
ioui- days, without other food than water. Phil Trans. 1684. — A
boy, fifteen years of age, said to have lived three years without

GE. v.] NOSOLOGY. 19

3. Pica. Appetite for improper and indigestible substances.
Pica. Sauv» Sag. Cull.
Citta. Linn.
Allotriophagia. Vog.
Vauket. Arab.
Massledigkcit. G.
Appetit bizarre. F.
ec Insulsa. From want of taste or discrimination : as in in-
fants or ideots.
Pica infantilis. Sauv.
S Perversa. From corrupted taste or indulgence: often
founded on empyrical or other improper advice, as
the eating of chalk or acids to produce a fair skin.
Pica voluntaria. Sauv.

either eating or drinking^ with fever occasionally, after this period
he recovered tolerable health, excepting the use of one of his limbs,
but even then took very little food. Id. 1720, by Patrick Blair. —
A man, said to have lived eighteen years on water — with occasion-
ally a Uttle clarified whey — and locked up for twenty days in close
confinement, with water alon*», to prove whether there were any
imposition : meagre, and supposed to have no evacuations, but in
good health, and pursued husbandry Id. 1742. — A woman, from
epileptic fits, when a girl of fifteen, took to her bed, lost her appe-
tite, and was attacked with lock-jaw, which, with a few short inter-
vals, continued for four years : was on two or three occasions in-
duced to take a little water, and her mouth was at times moistened
with wetted linen through a cavity in her teeth, from two of them
having been broken in an attempt to force the mouth open : but
swallowed nothing else. After this period, began gradually to re-
cover from the tetanus, but had no desire for food ; and twelve
years from the attack, when able to walk upright, took no more
food than sufficient for an infant of two years of age. Had no egesta,
but when ingesta, which were proportioned to each other, but
sometimes a dewy softness on her skin. Dr. Mackenzie., Phil. Trans,
vol. Ixvii. 1777. This case is authenticated by numerous witnesses
of high respectability, and is entitled to peculiar attention. — Case
of a woman, who lost all desire taking of food by a fall from her
horse into water during her first menstruation at the age of eighteen :
for fifty years scarcely ever took solids, her chief food being whey
in the summer, and milk, milk and water, or pure water, in the
winter: had frequent retchings, which were cured by smoking to-
bacco : for the space of sixteen years had only one stool annually,
in the month of March, resembling a globulet of sheep-dung : men-
struation never recurred, but occasional vomitings of blood. Edin,
Med. Ess. Vol. vi. p. 6. 4th edit.

20 NOSOLOGY. [CL. I.-OR. I.

Malacia (/*«>«*<«). Auct. Griec, So called from the soft-
ness and efieminacy of character (in Latin moUities) of
those, whether young men or young women, who ad-
dicted themselves to the above practice.

Found also, very frequently, as a symptom in chlo-
rosis, pregnancy, and several species of mental affec-
tion.
4. Cardialgia. Impaired appetite, with gnawing or burning
pain in the stomach or epigastrium and ten-
dency to faint.

3. Limosis Pica. The origin of pica is doubtful. Perhaps pica and
picatio,as it is sometimes written, are corruptions ofpecca and peccatio,
probably from the Hebrew p2 (pec), " to err, mistake, do wrong,
offend," though its common derivation is from " pica, a magpie."
Of the two varieties introduced into the text, the respective causes
are in direct opposition to each other: for while the last is from a
vicious habit, the first is from a vicious want of habit ; from not being
limited to what is proper, or restrained from what is improper.

Many of the Negroes in the West Indies are fond of eating common
dirt ; but whether from a depraved habit, or to supply the place of
food, does not seem clear. Dirt is eaten by many animals when severe-
ly pressed with hunger — as the ant-eater (myrmecophaga Jubata, the
pangolin (manis tetradactyla). and some species of the tortoise; and
they hereby diminish the gnawing pain which extreme hunger is well
known to produce. — Among the most unnatural tastes evinced under
this affection, but at the same time one of the most common, is that
for swallowing knives. In our own country it has occasionally oc-
curred ; but Plouquet, Init Bibl. art. Pantophagus, has collected ex-
amples from almost all the different states of Germany and the
neighbouring principalities, Basle, Prussia, Prague, and different
parts of Russia. Another curious propensity is that of swallowing
glass, of which also the instances are numerous. — Taste for eating
hairs, Bres/. Sammlung, 1719, p. 589. — For ordure, Borell. Obs. Cent.
iv. 2. Riedlin Lin Med. 1697. — Fourteen hundred herrings in
pregnancy, Tulpius.^ lib. iv. cap. 24.

4. Limosis Cardialgia. This and the two ensuiug species are
passed over by Cullen, whose example has been generally follow-
ed by succeeding nosologists ; the affections being regarded as
mere symptoms of dyspepsia : while Sativages, Linneus., and Sagar,
have made them distinct genera. The present system adopts a
middle path : It contemplates these affections as distinct species of
one common genus. That they are often associated with dyspep-
sia, or disease of the digestive function, is unquestionable ; but it is
equally unquestionable that they are not necessarily associated with
it, since they are frequently produced by accidental causes, during

GE. T.]

NOSOLOGY. 21

« Mordens. Gnawing or buring uneasiness felt chiefly at the
cardia, the tendency to faint being slight.
Morsus ventriculi. Lat.
Soda. Linn.

Cardialgia spuria.^ Aut. Var.
Kusof. Pers.
Brennen im magen. G.
Ardeur du coeur. F.
Heart-burn.

Found, also, occasionally as a symptom in dyspepsy, fla-
tus, scirrhus or inflammation of the stomach, worms,
and retrocedent gout.

the operation of which the digestive function and the digestive or-
gan are unimpaired and uninfluenced. Excited passions and in-
juries of the head are especially capable of generating these af-
fections in the soundest stomach.

6. Limosis Emesis. "'EfMo^n, from tftta^ vomo^ and hence the com-
pound " haematemesis" for a disease which belongs to cl. iii. Sau-
vages and Linneus regard nausea and vomitus as distinct diseases,
and even arrange them as distinct genera. This appears highly in-
correct ; for, if minutely examined, they will be found in every
case to be nothing mere than different degrees or modifications of
the same affection ; produced from a greater or less inversion of
the peristaltic motion of the stomach and oesophagus, and allayed
or overcome by the very same means. Where the stimulus, and
consequently the degree of inversion is slight, the effect is confined
to nausea : if beyond this, the nausea becomes retching, and the
retching becomes vomiting. They may, indeed, exist separately,
for the cause may be of a kind or strength sufficient to throw the
stomach at once into a state of violent inversion, and consequently
to produce vomiting without the common intermediate changes ; as
in the case of various metallic emetics, or sympathetic stimuli from
pregnancy, irritating the fauces, or the sudden sight or smell of
some offensive material. While, on the contrary, minute doses of
squills or ipecacuanha, or any other cause that produces but a slight
degree of action, will excite nothing more than nausea, on the first
stage alone of the inverted action upon which the general affection
depends. r

It is, nevertheless, curious and of great importance, to observe
the different and opposite effects produced on the animal frame by
these two stages of one and the same disease. Nausea lowers the
pulse, contracts the small vessels, occasions cold perspiration, se-
vere rigors and trembling, and diminishes, as long as it lasts, the
action and even the general powers of life. The act of vomiting,on
the contrary, rouses rather than depresses ; puts to flight all the pre-

22 NOSOLOGY. [CL. I.-OR. I.

C SyncopSlis. The pain or uneasiness extending to the pit of
stomach, with anxiety, nausea, coldness of the ex-
tremities, failure of strength, and great tendency to
faint.
Cardialgia vera. Aut. var.
Gastrodynia atterens. Sauv.
Aigreur d'estomac. F.
Sinking Heart-burn.
y Sputatoria. Burning pain extending over the epigastrium,
and accompanied with an eructation of watery fluid, usu-
ally insipid, sometimes acrid.
Cardialgia sputatoria. Linn,
Pyrosis Suecica. Sauv.
Pyrosis. Cull.

Apocenosis vomitus pyi'osis. Parr.
Dyspepsia pyrosis. Yotmg.
Cremason. F.
Wafer-brash. Water-qualm.
5. Flatus. Impaired appetite, with accumulation of wind in
the stomach or intestinal canal, and frequent
regurgitation.

ceding symptoms, and restores the system to itself. There are
few persons so debilitated as not to bear vomiting, but many
who would soon sink under nausea. It is obvious, therefore, that
these tvFO different states of the stomach may be employed as
powerful instruments in attacking a variety of general and even of
remote local diseases, this organ being justly considered as the com-
mon centre of sympathy, and producing opposite results according
as it is excited to different degrees of action.

The Greek physicians and physiologists, like the present system,
contemplated both these states of the stomach, as constituting one
common affection : and hence equally employed the derivatives of
iftiM and vavrixu to indicate each of them, whether nausea, vomitu-
ritio or vomitus. Thus, while the general meaning of j^m* is " to
reject,'''' Aristotle, in Problem, uses e^sT<«*» in the sense of '*• to retch
and to nauseate," as parallel with'-'- vomit iiritio and nausea: while
veivrins-t? was in frequent use to express the action of vomiting ; and
Galen, Lex Hippocr tells us that Hippocrates employed vxvriaaiif atS
synonymous with hsematemesis, or vomiting of blood.

Regurgitation is sometimes found to exist without vomiting, or
even disease of any kind : and it then constitutes rumination, from a
peculiar constitution of the esophagus. A singular case is related
by Dr. Slare, Phil. Trans. Vol. xvii. 1690— .3. The subject was an
adult man, who always ruminated his food, or had it returned into
his mouth for a second mastication about a quarter of an hour after

GE. v.]

NOSOLOGY. 23

Ereuxis (s^sul's-) Hippocr,

Flatulentia. Sauv, Linn.

Bombus. Vogel.

Blehung. G.

Ventosite. F.

Flatulency.
« Borborygmus. With frequent rumbling of the bowels.
C Eructatio. With frequent rejection upwards.

Rugh, or Arugh. Pers. Whence probably the Greek eg£i>y-#,
- and the Latin erug-o and rug-o.
y Crepitus. With frequent rejection downwards.

Zurat. ^rab.

Found also, occasionally, in one or other of these varie-
ties, as a syraptom in hysteria, hypocondriasis, dyspepsy,

colic, and cholera.
6. Emesis. Rejection of the contents of the stomach, or ten-
dency to reject.

Emesis. Plouquet.

^gritudo ventriculi. Danu. I. ii. 4. 4.

Sickness of the stomach.

the first ; till when it seemed to lie heavy in the lower part of his
throat. If he did not ruminate at the proper time, he soon became
sick. The writer notices other cases of a similar kind.

M. Majendie, of Paris, has lately been instituting a series of high-
ly curious experiments, to determine what are the parts chiefly
concerned in exciting the stomach to vomit. And from these it ap-
pears, that in nausea the action is confined to the organ of the
stomach alone, or perhaps in conjunction with the oesophagus;
that retching is produced by the contraction of the abdominal mus-
cles, and rejection by the contraction of the diaphragm alone, or
in conjunction with that of the abdommal muscles, and consequent-
ly that an emetic does not cause vomiting by iiritating the fibres or
nerves of the stomach, but by means of absorption and irritation
on the nerves of the muscles that surround the stomach In one
experiment M. Majendie entirely removed the stomach, and substi-
tuted a bladder, which he attached permanently to the base of the
oesophagus ; after sewing up the abdomen, he injected an emetic
into the animal's veins: it had nausea, made inspirations, and dis-
charged a coloured fluid which had been previously put into the
bladder, quite as well as it could have done with its natural sto-
mach. Rapport a Vhistitui JVcit. — In many of the present order of
diseases, however, the muscular contraction is unquestionably the re-
sult of sympathy.

7. Limosis Dyspepsia. Ava-Trtve-ix., " difficultas concoctionis.,''^ S«?,
male, and TrtTrrcD^ coqueo. Dyspepsia is here used in its more com-

24 NOSOLOGY. [CL. I.-OR. I.

« Nausea. Tendency to reject, but without regurgitation.
Ekrah. Arab. Most of the inflections of this word import
sickness, loathing, oppression, heaviness, griet, like the
Latin asger, aegra, of which it is probably the root.
Eckel. G.
Degout. jP.
Loathing.
C Vomituritio. Ineffectual eifort to vomit.
Dysemesia, (5y«|te£«-<«.) Auct. Grec,
Vomendi conamen inane. Darzo. i. lii. 1.8.
Bemiihung zum brechen. G,
Envie de vomir. F,
Retching,
y Vomitus. Act of vomiting, or rejecting from the sto-
mach.
Vomitus. Linn.
Palmus vomitus. Young.
Kceji. Arab.
Erbrechen. G.
Vomissement. F.
Vomiting,
The one or the other variety found also occasionally,
as a symptom in colic, colera, lithia, the accession of
fevers, and various aflfections of the head.

mon and restrained acceptation : a sense not quite so limited, in-
deed, as that of Fogel, who first copied the term from Athenaeus,
but considerably more so than that of Dr. Cullen and Dr. Young, as
already observed in the note on Limosis ; and nearly parallel with
the range assigned to it by Dr. Parr, who has also reduced it to a
species, as in the present instance, his generic term, however,
being not limosis, but anepithymia.

In most of the nosologies there has been as great a difl&culty felt
in knowing under what order to place this genus or species, as in
determining what it should comprise : thus Cullen and Parr ar-
range it under their order of adynamics, the latter however sinking
it, as in the present classification, into a species ; while in Crichton
it occurs under the order dolores ; and in Dr. Young, under that of
cacochymioE or cachexies.

In that entertaining and valuable work, the Swedish Amcenitates
Acadeiaiccz, the reader will find various articles well worth consult-
ing upon the disease before us: particularly the four following:
'■'- Fervidorurn et Gelidorum Usus,'" by M. C. Ribe, 1765, vol. vii.
art. 136 ; and the next article by M. B. C. Tillaeus, entitled " Pa-
ins ThecB ;" in both which the writers seem to ascribe most of the

GE. v.] NOSOLOGY. 25

7. Dyspepsia. The appetite fastidious, and the food digested
with difficulty.
Dyspepsia. Vog. Parr.
Anorexia. Sauv. Linn. Vog. Sag.
Memouk. Jrab.
Uhverdaulichkeit. G.
Indigestion. F.
Indigestion.
«, Sedentaria. From a sedentary habit of life.

Daubenton found doses of ipecacuhan, not exceeding
gr. ij highly useful. Mem. de la Soc. Med. Royale.
€ Metastatica. From transfer of morbid action, as in repel-
led gout or cutaneous eruptions.

disorders of the alimentary canal, and the digestive functions, to the
perpetual use of tea, and attempt to show that the increase of these
diseases is referable to the increase of this deleterious practice.
The third and fourth papers I refer to, are still more interesting
and valuable : the first of these is by M. Suensson, entitled " Panis
Dioeteticus^^'' vol. v. sec. 79, year 1757 : and offers an ingenious in-
quiry into the various sorts of grain used for bread in different parts
of the world, whether leavened, unleavened, or fermented ; de-
scribes the comparative advantages and disadvantages of each, and
their effects on persons of weak habits and a sedentary life ; and
lays down various useful remarks, and points out various errors in
the process of making bread. The substances chiefly examined
are rice, Turkey wheat, millet, and sago, with the following sub-
stitutes for bread employed in different parts of the globe : cassava
(root of Jatropha majiiot) ; potatoes ; yams ; sea-rush (root of scir-
pus maritimus) ; drop-wort (root of spirosa Jilipendula) ; clown's all-
heal {stachys palustris) ; Iceland liverwort ; bark of the wild pine
(pinus sylvestris) ; still used in Dalarne ; chesnuts ; spurrey-seeds,
{spergula arvensis) ; and the berries of the lotus of Pliny (jhamniis
lotus,) still had recourse to by some of the African tribes.

The fourth paper here referred to, is numbered 84 in the same
volume, and entitled " Culina mutata,'''' by M. M. G. Osterman. It
may be regarded as a valuable continuation of the preceding : for
the author enters into an interesting examination of the change that
has taken place in the choice of vegetable aliments since the time
of the ancients, and concludes altogether in favour of those of mo-
dern origin. The nuts and acorns of the primitive days have given
Avay to all the variety of the sweeter farinaceous seeds and roots.
To the malvaceous tribes of plants, so much used by the Greeks
and Romans, has succeeded the more grateful spinach ; and to the
blite, the garden orach. The acescent sorrel has taken the place of
the rough borage, and the asparagus has banished a number of roots,
recorded by the Roman writers under the name of bulbs, though at
4

!26 NOSOLOGY. [CL. I.-OR. I.

y Antipathiae. The fastidiousness or aversion confined to

particular foods. Chiefly, perhaps, contracted in early

infancy by the accidental association of unpleasant or

nauseating ideas with particular aliments.

Found also, occasionally, as a symptom in icterus, para-

bysmus, hypocondriasis, hysteria, chlorosis, pregnancy,

dropsy, and various fevers.

GENUS VI.

COLICA.

Griping pain in the bowels, chiefly about the navel, v/iih
vomiting and costiveness.

present it is not easy to determine the several species. M. Oster-
man, however, thinks that the parsnip should not have supplanted
the skirret. The bean of the ancients, improperly so called, (being:
the root, as well as the other parts of the Indian water-lily, nymphcz
nelumho)^ is properly superseded by the kidney-bean. The garden
rocket, formerly eaten with the lettuce to counteract its chilliness,
is banished in favour of the more pleasant tarragon and cresses;
the apium in favour of the melioriited celery ; the pompion, and
others of the cucurbitaceoun tribe, have yielded to the melon ; and
the berries of the sumacb to the fragrant nntmeg The silphium
(^succus Cyrenaicus^ which the Romans purchased from Persia and
India at a great price, and which by some is supposed to be the asa-
fostida of the present day) has been proscribed in behalf of the allia-
ceous tribe. Among the animal substitutes, the author observes
that the carp has deservedly excluded a number of fishes held in
high estimation in ancient Kome. He also points out the beneficial
change of oil for butter; of honey for sugar; of mulsa (liquors
made with wine, water, and honey) for the exquisite wines of mo-
dern times ; and of the zythus for our present improved malt liquors.
And he notices also the exchange of the calida of the Romans for
the more exhilarating tea and coffee of modern times.

Gen. VI. CoLiCA. From «a»a«v, " colon," the chief seat of the dis-
ease.— There are four genera of diseases in Sauvages's Nosology :
gastrodynia, colica, rachialgia, and ileus, whose more prominent
symptoms so closely resemble each other, as to indicate their being^
a sort of natural tribe, or family. And Dr. Cuih^n has hence, with
great judgment, simplified them into one genus under the common
name of colica. The present arrangement follows him thus far,
afid only differs from him in attemptipg a greater simplicity in its

GE. VI.] NOSOLOGY. 27

Colica. Cull.
Koleng. Pers.
Grimmen. G.

Colique. Douleur au ventre. F.
Colic. Belly-ache.
I. Ileus. With retraction of the navel, and spasms of the
muscles of the belly;
Jleus (tMoi). Hippocr.
Colica spasmodica. Cull.
Ileus spasmodicus. Sauv.
Chordapsus. Cels.
Passio iiiaca. Junck.
<c Faecosa. The vomiting accompanied with feces or sub-
stances injected bj the anus.
5 Inflammatoria. Accompanied with symptoms of inflam-
mation.
Ileus inflammatorius. Sennert.
Colique inflammatoire. Tissot.

species, in adding that of colica flatulenta (wind colic) from several
preceding nosologists, and in employing the established terms ileus
and rachialgia as specific names, instead of adopting the new and
even less correct terms which CuUen has proposed in their stead.
Ileus is a word entitled to veneration, from its having descended to
us from the first Greek authorities: it is descriptive of the com-
mon seat of the species, and is still in use all over the continent.
Nothing is gained by exchanging colica ileus for colica spasmodica ;
while the latter term is not a little tautological and inelegant as the
name of a species in Cullen's arrangement, which has already placed
the entire genus under the order of spasmi, and hence doubly de-
nominates it " a spasmodic spasm." In the second species perhaps,
the most essential symptom (if we may borrow such a term from
the botanists) is the peculiar pain that strikes through to the back ;
on which account Astruc first gave it the name of rachialgia (^back-
ache), a name highly proper in itself, and which has been, and, on
the Continent, still continues to be, in more general use than any
other. For colica rachialgia, however. Dr. Cullen has given us co-
lica Picto7ium, a term, indeed, derived from Sauvages, who at the
same time continues rachialgia, in consequence of his making, as
already observed, an unnecessary distinction between the two com-
plaints. Now while rachialgia has the advantage in point of anti-
quity, it has an equal advantage in point of correctness and univer-
sality; for it applies, in a greater or less degree, to all the varie-
ties of this species, while Pictonum is limited to a single variety,
namely, that which results from the beverage of the Pictonese, or
inhabitants of Poitou. On this account, therefore, the author has

2Ti NOSOLOGY. [CL. I.-OR. I.

2. Rachialgia. The pain at first dull and remitting ; but pro-
gressively growing more violent and con-
tinued ; extending to the back and arms,
and at last producing paralysis.

Colica pictonum. Cull, et Aut. Var.

Rachialgia. Astruc. Sugar.

Rachialgia Pictonum, spec. 1. r. metallica 3. Sauv,

Paralysis rachialgica. Sauv.

Colica nervosa. Macbride.

Palmus plumbarius. Young.

Mahler-grimmen. G.

Colique de Poitou. C. de peintres. F.

Devonshire colic. Painter'^s colic.

preferred the original to the more modern term ; but has still ad
hered to Culien as closely as he has been able.

Most of the nosologists have felt considerable difficulty in deter-
mining the place of colica as a genus, in their respective arrange-
ments. The most striking characters of it are the abdominal pain,
vomiting, and costiveness, at the commencement : the vomiting be-
ing much more violent in c. ileus than in the other species, and in
this only accompanied with stercoraceous matter. The pain there-
fore has been generally taken as a directory for the position of the
disease by those nosologists who have admitted a class of dolores^ as
Sauvages, Linn^us, Vogel, Sagar, and Macbride ; all of whom, how-
ever, having followed each other in making a generic distinction
between colica and ileus, have, in like manner, followed each other
in fixing the last under Jluxus, or evacuations. Dr. Cullen's system
has no such class as dolores, and he was consequently obliged to
search out for a local habitation of a different kind. The great and,
in many respects, beautiful simplicity of his method, however,
which contains only four classes, febrile, nervous, constitutional and
local diseases, rendered it peculiarly perplexing to determine upon
which he should fix. Perhaps the last, which can only be regard-
ed as an appendix to the three preceding, uiight have been the most
appropriate, especially as it embraces anorexia and constipatio,
which are nearly connected, both anatomically and symptomatically,
with colica. Such, however, was not the opinion of Dr. Culien,
who at length fixed upon the class 7ieuroses, or nervous diseases, and
the order spasmi^ as its proper place ; and who has been followed
in this decision by most subsequent nosologists of our own country,
as Crichton, Parr, and Young.

The arrangement now offered would have allowed the author to
copy the same example, if it had not appeared to be equally indefi-
nite and incorrect. Colic is, properly speaking, a disease, not of the
nervous, but of the digestive function; all the digestive organs are
affected by it, and excepting by sympathy, no other. Spasm, which

GE. VI.] NOSOLOGY. 29

tt Venenata. From mineral and other poisons: of which
lead is the most frequent; whence the name of Pain-
ter^s colic.
C Ab acidis ingestis. From acid or acidulated drinks; of
which crude wines and cider are the most frequent :
whence the name of Poitou and Devonshire colic.
y A frigore. From cold, or suppressed perspiration, tech-
nically denominated adiapneusiia.
i A contusione dorsi. From a blow or other injury on
the back.
These varieties, derived from the remote cause, are
copied with little alteration from Cnllen.
3. CRAPULOSA. The pain accompanied with nausea, headache,
and dizziness, before vomiting, and often ter-
minating in a griping looseness.
Colica accidentalis 18. c. meconialis 19. c. lactentium

20. Sauv,
Colica accidentalis. — c. meconialis. CulL
■ Colique d'indigestion. Tissot.
Colic from indigestion.

Produced by eating indigestible aliments, or digestible
aliments in too great abundance. In this species the vo-

ought to be its leading character, if its proper place be under spasmi,
is no generic character of it at all. It does not enter into the generic
definition of any writer who has thus arranged it; and if it did, it
would by such definition exclude various species which are now
commonly regarded as rang ng under it ; as Cullen's c. callosa, (from
a scirrho-contracted rectum.) c. calculosa, and, in many of their va-
rieties, c. stercorea and c. accidentalis (c. stipata of the present sys-
tem) : for though vomiting may, in a certain sense, be called
spasm, this is not the spasm here intended. To one species, how-
ever, the term is peculiarly applicable, c. rachialgia, which, from
this circumstance Dr. Cullen, as already observed, has denominated
c. spasmodica; but then this symptom becomes a specific and not a
generic character, and consequently ought to have no power in fix-
ing the genus.

2 a. C. Rachialg. venenata. This is not unfrequently produced
by merely sleeping in newly painted rooms. Is the lead in this case
in a state of metal, oxyd, or salt? Is it dissolved in the air, or mere-
ly mixed with it? The author has met with various instances of a
most decided character from this cause alone. See also M. Armand
Seguin, Annales de Chimie, Ixxxviii. p. 263. The author has met
with other instances of the same variety of disease from long resi-
dence in close damp rooms filled with newly printed or coloured pa-
per: but not from damp paper, unless newly printed or coloured.

30 JJOSOLOGV. [CL. I.— OR. I.

miting or looseness, or both together, frequently operate
a cure. The indigestible materials are often fruit-stones,
or kernels, which have sometimes remained so long as to
germinate before their rejection. — See a description of
cherry-stones in this state, by M. Devillaine, Journ. de
Med. torn, xxxvii. — of plum-stones, Eph. J^at. Cur. Dec. i.
iii.
4. FLATULENTA. The pain acute; extending to the. pit of the
stomach, often impeding respiration ; ac-
companied with great fulness and flatulen-
cy : and relieved by pressure, bending the
body forward, or expulsion of wind.
Inflatio. Aetius.
Gastrodynia flatulenta. Sauv.
Colica flatulenta. Parr. Art. Colica^
Ileus physodes. Relfinc.
Wind-grimmen. G.
Colique venteuse. F.
Wind-colic.

Produced by crude and flatulent fruits, and whatever
lowers the tone of the alimentary canal ; as too long fast-
ing, fear or grief; and hence common among children and
hypocondriacs.
b. sTiPATA. The pain severe ; the costiveness obstinate ; great
tension, with little flatulency : the vomiting
sometimes accompanied with feces ; the costive-
ness with bloody strainings : terminating, where
not fatal, in a free dejection of the infarcted
matter.
» A vicido meconio. From viscid meconium.
Colica meconialis. Sauv. Cxdl.
Tranchees des enfans. F.
6 A faecibus induratis. From indurated feces.
Colica stercorea. Sauv. Cull.
Ileus a faecibus induratis. Sauv.
y Ab enterolitho. From bezoards and other intestinal con-
cretions.

5. y C. stipat. M enterolitho. The Phil. Trans, contain many
extraordinary cases of this kind. The most singular, and one of the
best related, is in No. 3, year 1681, continued in No. 181, year
1G86, by Dr. Konig-, of Bern. The patient, Margaret Lower, a
young woman of twenty-five, discharged continually the contents of
(he intestines, and even the clysters that were injected, by the

GE. VI.] NOSOLOGY. 31

Colica calculosa. Sauv. Qdl.

Ileus calculosus. Sauv.
6. CALLOSA. With a sense of stricture in some part of the in-
testinal canal ; often of flatulency and pain,
the flatulency gradually passing oft' by the
stricture : the bowels tardy ; at length dis-
charging small liquid stools.

Colica callosa. Cull.

Ileus a callosa coli strictura. Sauv.

GENUS YII.

COPROSTASIS.

Obstinate retention of the feces in the intestines.
Adstrictio. Cels. Gal.

mouth, and at length a number of stones as hard as flint, some in
fragments, some of the size of peas, others of that of filberts. A
clashing of stones against each other was felt by pressing the hand
upon the abdomen: there was great constipation, severe gnpings,
disury ; and the urine, when voided, was oftt n loaded with a gravelly
matter. The aliment and injections being constantly returned by
the mouth, Dr. Konig desisted for four months from oiTering her
either meat, drink, or medicine of any kind, excepting occasionally
a spoonful of oil of almonds Blood was now and then vomited from
the violence of the spasmodic action of the stomach ; and frequently
urine, to the amount of three or four ounces at a time, of a strong
taste and smell. The disease seems to have lasted with remissions
from January 1768 to February 1703, at which period the history
is abruptly dropped, though the patient seems to have been in a
state of recovery. It was preceded by tlie appearance of vesicular
eruptions in the skin, and was probably produced by their repulsion.
The chemical examination of the calculi is loose and unsatisfactory.
6. Colica callosa. The stricture here referred to is the scirrho-
contracted rectum of surgical writers. It lies beyond the reach of
topical remedies, and is chiefly to be alleviated by a rigid attention
to light, liquid and aperient diets. 'J he disease is a lamentable,
though not a common one : yet the writer of this work has, at the
present time, three patients afflicted with it under his care : one a
lady of twenty-four years of age, who has been a sufferer for about
wo years J another a lady of thirty-five, who has been subject to it
lor ten years ; neither of whom is capable of passing feces more vo-

32 NOSOLOGY. [CL. I.-OR. I-

Obstipatio. Linn. Vog. Sag. Cull.

Stjpsis. Plouquet.

Constipatio alvi. Darw.

(Kebz.) Arab.

Stopfung. G.

Constipation. F.

Costiveness.

1. COACTA. The feces, when discharged, impacted and volu-

minous ; the temperament firm and rigid.
Obstipatio rigidorum. Cull.
Enkebaz. Arab. .

Probably the result of increased action of the intesti-
nal absorbents.

2. ADSTRicTA. The feces, when discharged, hard, slender,

and often scybalous ; the temperament weak-
ly, or the habit sedentary.

Obstipatio debilium. Cull.

Husr. Arab.

Probably the result of diminished peristaltic action.

luminous than those of an infant; and the third, a man of fort)'-nine
years old, who has laboured under the disease for twenty-one years,
and can never pass a motion larger than a crow-quill. Yet, by
strict attention to diet, all three are able to exist with only occa-.
sional inconvenience and pain ; the last married about two years
since, and his wife has lately brought him twins. He lives upon
liquids altogether.

Gen. VII. CopRosTASis. K«wg»9-T«y<5. from xo^gs; fceoes, and
<Trx(j-ii, from nrrnftt^ stagnasio, emansio : literally "retained feces."
Hence the compounds coprorrhaea, " fecal metastasis," copragoga,
" gentle purgatives ;" copriemesis, " a discharge of feces by the
mouth," and various others. Obstipatio, as usually employed to sig-
nify costiveness, is altogether inadmissible : it has no authority
among classical writers; and, if used in medicine at all, should ra-
ther mean arthritic obliquity or contraction, the obstipitas of Sauva-
ges, contrnctura of Cullen, and especially the caput-obstipum (gen.
Dxy.) of Vogel. The common term with Celsus and the Latin writers
is adstrictio, as its opposite is solutio. The alvus adftricta, however,
applies rather to the second species in the present genus than to the
first ; for if the feces be voluminous as well as indurated, they are
called by Celsiis coactcc: a term in like manner applied to the intes-
tinal canal itself when thus loaded, lAh. II. cap. iii ahiis coacta. It
is on this account the author has preferred the terms coacta and ad-
stricla, as the trivial names for the species of this genus, to Dr.
Cu lien's terms rigidovwn and debilium.

GE. VIII.] NOSOLOGY. 33

GENUS VIll.
DYSENTERIA*

Griping and tenesmus ; frequent, mucous, and often bloody

2. c. Coprostasis adstricta. As the cause is widely different in
these two species, the means of relief must be equally so. The
saline purgations, or nauseating doses of calomel and ipecacuhan, or
of calomel and antimonial powder, will be found chiefly useful in the
former, and warm aromatic purgatives in the latter. Here, how-
ever, the disease occasionally resists purgatives of every kind ; the
accumulation is prodigious, and evacuation does not occur for weeks
or months. In the case of a young woman aged twenty-eight, the
distention of the abdomen was so general as to be mistaken for preg-
nancy, especially as there was occasional sickness, menstrual sup-
pression, and sympathetic enlargement of the breasts. The case
terminated fatally in about three years from its commencement.
The colon, which is preserved by Mr. Taunton, who has obligingly
shewn it to the author, as well as favoured him with this history,
measures, in circumference more than twenty inches, and on dissec-
tion was found to contain three gallons of feces.

Tardiness of evacuation, however, is not always a disease : for
some persons are accustomed to have their bowels moved not ol-
tener than twice a week, and to such a week's costivenessis attend-
ed with no inconvenience. Chaptal mentions the case of a female
patient, who for four months had no discharge either from the bow-
els or kidneys, and as little evacuation by sweat, notwithstanding
that her diet was confined to milk-whey, and broths. She was at
length cured by using the cold balh for eight days successively.
The disease was ascribed, and perhaps rightly so, to too copious a
flow of insensible perspiration : in which case rigors excited by
nauseating medicines, as squills or small doses of ipecacuhan, might
have had a speedier success than ihe use of the cold bath.

Feces retained six months. Sabmiih. Cent. 1. obs. 'i4. — Two
years. Samm lung Medic. Wahrnelmmngen,, Land. iv. p. 294. — Three
years. Journ. des Scavans, 1693. — Seven years. N. Samml. Med.
Wahrnem. band. i. p. 423.

Quadrupeds, that ruminate or possess complicated stomachs, and
use little exercise, are peculiarly subject to the second species,

* [In the " Study of Medicine," Dr. Good has transferred di/senieria to the
ihirdC\a.ss,a\\d second oi-det. In that order it constitutes the /«;V/t genus. The
author's reasons for this change will be found in the " Study of Medicine." We
have thought it best to follow the original in both works, leaving the author's
own explanations for the very few cases in which there is a want of correfpojv-
dence, ^»i. Publishers.]
5

34 NOSOLOGY. [CL. I-OR. I.

dejections ; the feces seldom discharged, and in small
quantities.

which indeed is the chief cause of the disease in the present sys-
tem denominated enterolithus. See e:en. xi of the present order.
Gen. Vlli. DvsENTERiA. Lvnm^tu,^ from St-s "• male," and i»Tip«r,
" intestinum." By Coelius Aurelianus, Akenside, Richter, and SloU,
regarded as an intestinal rheumatism; by C'ullen ascribed to speci-
fic contagion ; and by Andre, Nyander, and other followers of Lin-
neus, as long before by Kircher, to animalculi. Amen. Acad, v, 82.
— Dr. Hagstroom, embracing this last opinion, employed the nux
vomica, and, as he asserts, with considerable success. Linn^us de-
scribes the supposed animalcules in his Syst. Naturce^ under the
name of acarus dysenteriae. Holander, who laboured several times
under the disease, while residing with Linneus, pretended to disco-
ver that these animalcules were conveyed into his body in water
received from a vessel made of juniper wood. But Bnilbn has long
since observed, that animalcules may be traced in all animal fluids,
and especially those of the intestines, after rest and exposure to a
warm atmosphere. (See the note on Helminthia, Gen. xii.) — In
Rolander's case the disease was probably not contagious ; for not-
withstanding the recurrence of the complaint in himself, there was
no other sufferer in the house.

Dr. Cullen regards dysentery not only as always contagious, but
as always accompanied with fever; and, according to his nosological
arrangement, with fever as its leadmg symptom, to which all the
rest are subservient. He has hence placed dysentery in the class
pyrexias, order profluvia, and has given it as his opinion that the ge-
nus possesses but one species, "• the epidemic dysentery with fever"
of Sydenham (cap. iii. sect. 4) ; which is Sauvages' species 6, the
camp dysentery of Ram.azzini and Pringie, and the hospital dysentery
of C. Monro. In consequence of which he opens his definition by
styling it pyrexia contagiosa.

NovT, neither of these terms are to be found in the generic cha-
racter of perhaps any nosologist, who has not immediately copied
from Cullen. In Sauvages, Linneus, Vogel, Sagar, and Macbnde, it
occurs under the division, not of fevers, but of Huxes, without any
notice of lever or contagion except in some of their species. Dr.
Parr, indeed, and Dr. Young place it, not exactly in the division of
pyrexiie, but in that of phlegmatiee or phlogisini. which nearly an-
swer to each other; while the former gives us a subdivision which
he expressly declares is not epidemic (dysenteria spo adica ;) and the
latter makes it a part of the definition of the genus defiuxio, of
which dysenteria is rendered a species, that it is only "often conta-
gious," a limitation which is not varied, and must therefore be sop-
posed to hold good in the specific character it^clf.

In the i)resent arrangement, the auiiior has chiefly taken Syden-
ham as his pole-star, whose view of the disease has tjest harmonized

GE. Vni.] NOSOLOGY. 35

Dysenteria- Hippocr. Saiiv. Lin. Vog. Sag.
Dysenteria, an. 1669-72. Sydenham.
Megs. Arab.

with whatever degree of personal knowledge of it has fallen to his
own share His description, as deduced from section iv. cap. i. and
iii. appears to be in few words as follows : In the year 1662, cho-
lera, dry gripes, or colic without stools (immania ventris tormina
sine dejectionibus,) and dysentery, were very frequent. In the fol-
lowing autumn the last two diseases returned : and in the midst of
their raging appeared a new kind of fever (novum febris genus)
which accompanied both diseases, and not only seized those that
were afflicted either with the one or the other, but even those that
were free from each ; resembling the lever that not unfrcquently
(non infrequenter) attended the two preceding diseases, and which
was hence distmguished by the name of the febris dysenterica.

Omitting the consideration of the tormina or gripes, we here meet
with a brief account of 1 . simple dysentery, or without fever ; 2. dys-
entery cotnplicated with the fever that not unfreqventhj attended it ;
and 3. a new fever resembling this last. And we also tind that sim-
ple dysentery, or that without fever, may at times be epidemic or
contagious, as well as that with fever.

The foregoing passage, however, forms only the opening of the
first chapter. It is in the third that this admirable observer and ex-
cellent writer enters fully upon the description of the epidemical
dysentery of the period before us; in which he tells us, that in the
course of the autumn of 1669 the dry gripes (ventris tormina sine
dejectionibus) and dysenteries raged nearly equally ; and that " some-
times a fever accompanied them^ and sometimes not ;" febris nunc iis ac-
cessit, nunc aberrat. "At times," says he, " the dysentery commen-
ces with rigor and shivering, succeeded b}' a heat of the whole body,
as is the case, in fevers — hut frequently there is no appearance of fe-
ver^ for the host of gripings take the lead, and the dejections follow."
He pursues his description of the simple dysentery^ or that without fe-
ver, observing that in this species an excrementitious stool is some-
times interposed without considerable pain ; and then enters upon the
species accompanied withfever. " In the mean time," says he, " if the
patient be in the vigour of life, or has been heated by cardiacs, a
fever arises^ his tongue is covered with a thick white mucus, and if
he have been much heated, it is black and dry : there is great pros-
tration of strength, exhaustion of spirits, and every symptom of an
ill-conditioned fever."

It is not necessary to pursue his description of this second species
further. It must be obvious to every one, that in the opinion of Sy-
denham, dysentery, as a genus, embraces at least two distinct spe-
cies, both of which, at the period of his writing, were epidemic ; the
one of a milder nature without fever, the other of a malignant nature
with it.

36 NOSOLOGY. ^CL. I.-OR. I.

Tormina. Cels,

RoLhe-ruhr. G,

Flux de sang. Djssenterie. F.

Blohdy-jiux, Dysentery.

1. SIMPLEX. Unaccompanied Avith fever : the feces, when dis-

charged, evacuated without considerable pain,
of a natural quality, and affording ease.

2. PYRECTiCA. Accompanied with fever, great loss of strength,

and depression of spirits : the feces, when
discharged, of various colours and consis-
tence ; highly fetid, and mixed with putrid sa-
nies, sebaceous matter, or membranous films.

Dysenteria. Cull.

Febris dysenterica. Sydenh.

» Caumaiodes. The accompanying fever being a cauma.
Dysenteria inflammatoria. Macbr.

G Typhodes. The accompanying fever being a typhus.
Dysenteria putrida. Macbr.

GENUS IX.
DIARRHCE-A.

Alvine evacuations crude, loose, and too frequent : with
little or no griping or tenesmus.

The former of these is often met with in private practice, of spo-
radic origin, and without evincing any contagious character. The
latter is perhaps, as Br. Cullen asserts, at all times contagious. Since
writing the above, the author has met with Dr. Harty's " Observa-
tions on the Simple Dysentery and its Combinations, containing a re-
view of the most celebrated authors who have written on this sub-
ject ;" in which much of his own opinion is confirmed, and copiously
illustrated. The proper place for dysentery, therefore, appears to
be that now selected : the febrile or complicated species, might, in-
deed, be introduced under the class pyrectica, but not without con-
fusion, and in repugnance to all the rules of correct classification, as
separating it from its fellow species.

Gen. IX. DiARHH(EA. A»app8««, " perfluvium :" a " flux," or " run-
ning through :" from ^lu^'^tu "• perfluo, diffluo." The term is com-
mon to all the Greek writers.

The species are, with a slight alteration, those of Dr. Cullen; who
has judiciously introduced d. chylosa or cceliaca, and lienteriainto the
number, instead of regarding them as distinct genera. Sauvagesin-

GE. IX.j NOSOLOGY. 37

Cacatoria. Gal,
Defluxio. Cccl. Aur.
DiarrhcEa. Ktoteric.
Eshal. Arab.
Bauch-fluss. G.
Cours de ventre. Foire. F.
Lax. Looseness.

1. FusA. Feces of common quality, but immoderately loose,

and copious.
Diarrhoea stercorea. Young.

2. BiLiosA. Feces loose, copious, and peculiarly yellow.

3. MUCOSA. The dejections consisting of, or containing a copi-

ous discharge of mucus.

Ascribed by Cullen to acrid ingesta, or tak-
ing cold, particularly in the feet.
Diarrhoea pituitaria. Sauv.
Pituitaria. — Leucorrhois. Vog. 111. 112.
Diarrhoea lactentium. Sauv.

When produced by cold it forms the catarrhus intestino-
rum of various authors : the motions are acrid, often with
but little bilious tinge, and the lov.-er part of the rectum is
excoriated, like the nostrils in a coryza.

4. CHYLOSA. The dejections milky or chyliform.

Coeliaca chylosa, 1. — c. lactea. Sauv.
Diarrhoea chylosa. Young.

5. LiENTERTA. The dejections consisting of the aliment passed

rapidly and with little change.

6. SEROSA. The dejections almost entirely liquid.

Diarrhoea serosa. Sauv. Young.

deed seems almost to have persuaded himself to pursue the same
simplifying plan, upon a suggestion of Paulus jEgineta : " Lienteria,"
says he, " videtur diarrhosoe species, non vero genus distinctum, aut ad
summum, ut notat Paulus Jilgineta, cosliacd non nisi gradu differt."
It is singular, that with this view of the subject he should have allot-
ted a distinct generic place to each of these. Dr. Young has ex-
changed the term coeliaca for chylosa ." a term selected also by Sau-
vages, though under coeliaca as a genus. As Cceliaca is here em-
ployed as the name of the class, the author has preferred chylosa as
the name of a species. Lienteria, {lubricitns, not laevitas intestinorum,
as usually explained) was employed b}' the Greek physicians under an
idea that in this species the food slides rapidly along the course of the
intestines, from a peculiar lubricity or smoothness at such time pos-
sessed by them. The idea is erroneous, but the term, as indicative
of fleetness of passage, may still be retained.

38 NOSOLOGT. [CL. I.-OR. I.

Diarrhoea aquosa. Hofm. ii. p. 117. Parr.

Frequently metastatic, and still oftener produced by
elaterium, or other drastic purgatives. Sometimes urinous :
occasionally tinged with blood.
Watery looseness.

GENUS X.
CHOLERA.

Anxiety, gripings, spasms in' the legs and arms; for the

most part with bilious vomiting and purging.
Cholera (j^eXtpx) Aucl. Grac. Sauv. Cull.
Cholera morbus. Auct. var.

6. Diarrhoea serosa. A young woman, aged twenty-four, applied
to the author in August 1806, with a disorder of this species, which
had continued for ten years, and had never produced fewer than
nine or ten watery stools a day, sometimes tinged with blood. She
was often in great spasmodic pain in the stomach or intestines ; and
had tried a long list of astringents, anodynes, and other medicines, to
little purpose. She was much reduced, and it appeared to be a case
of great local irritation from local debility. Gentle stimulants were
here of essential service, and the disease gradually yielded to cam-
phor mixture and pills of the resinous gums.

Gen. X. Cho! e'^a. This term has been in use from the time of
Hippocrates ; and is supposed by Celsus to be derived from ji^oXti bile.,
and fiu to flow., (literally bile-Jlux ;) though Trallian traces it from
jjeX«5, (in intestine., and pj6> (literally bowel-flux.) The first two species
now offered are upon the authority of the Greek physicians, con-
firmed by the experience of various modern writers, and especially
of Sydenham To admit the second and third, however, it has been
necessary to limit in some degree the last clause of the generic defi-
nition by the adverb pla-unKjue., " for the most part," which is not in
Celsus, from whom the definition is taken generally. Cullcn has
rejected the second species, notwithstanding the preceding authori-
ties, and others have conceived it to be more properly a species of
colic ; but as the remaining symptoms which contradistinguish cho-
lera from colic, and especially the anxiety and spasmodic contraction
of the extremities, are equally present in the flatulent and in the
common species, we eannot separate them without confusion. They
are both produced by various and the same causes, as surfeit, animal
and mineral poisons; both at times take place spontaneously, or

GE. X.]

NOSOLOGY. 39

Oben und unten purgiren. G.
Trousse-galant. Tissot.
Purging and vomiting.

1. VULGARIS. The vomiting and purging frequent and copious.

Cholera morbus. Sydenh.

2. FLATULENTA. The vomiting and purging rare or absent ;

great and oppressive flatulence ; retching ;

flatulent dejections and eructations.
Cholera sicci. Sydetih. Sauv.
C. |«g«. Hippocr.
C. arida. Gal.
C. flatulenta. Menjot.

3. SPASMODICA. The dejections watry ; ineffectual retching ;

spasms successive and violent, commencing
in the thoracic and abdominal muscles.

without any obvious cause, especially towards the decline of sum-
mer ; and both are at times epidemic : though Sydenhrtm admits,
that in the epidemic cholera of 1669 he met with but a single in-
stance of the dry or flatulent species ; — " unicum dimtaxat exemplnm
me vidisse memini ineunte hupis anni antitmno.'''' cap. ii. The third
species is now for the first time introduced into a methodic system
upon Mr. Curtis's authority.

The species of Cullen are derived from the diversity of cause
alone; and are hence improperly called species; for the disease,
and all the symptoms of the disease are or may be the same. His
species, which can only be considered as varieties, are c. spontanea,
and c. accidentalis : cholera produced spontaneously and by accident.

In Dr. Young's system, cholera itself is made a species of diarr-
hoea ; but the vomiting and spasms of the extremilies ofl'er marked
characters tor a separate genus. In br. Parr's article Nosology it
occurs as a species oi vomiius^ and forms an associate with pyrosis,
which is almost as much out of its proper place. Nor is its classical
or ordinal place in Cullen much more correct, since he makes it a
genus of nervous diseases under the order of spasms: — an arrange-
ment which, like both the preceding, is founded upon a single svmp-
tom.

3. Cholera spasmodica. — Mr. Curtis has well described this dis-
ease. He regards it, and perhaps justly, as a new species, and pro-
poses to call it spasmodic cholera, iVom the violence and extent of
the cramps; though the vulgar name given to it in the Madras
Naval Hospital is as above. Soon after the attack " the sjiasm-,' he
tells us, " began to affect the muscles of the thighs, abdomen, and tho-
rax, and la.^tly they passed to those of the arm?, hands, and fingers :
but 1 never saw then or afterwards, those of the neck, lace, or back,
at all affected. The rapidity with which these spasms succeeded the

40 NOSOLOGY. [CL. I.-OR. I.

Mort de Chien. Curtis, Account of the Diseases of India,
8vo. 1807.

Species 1 and 2 found also symptomatically in gout
worms, enteritis, and intermitting fevers.

GENUS XI.

ENTEROLITHUS.

Stony concretions in the stomach or intestinal canal.
1. Bezoardus. In concentric layers closely agglutinated or
crystallized ; capable of a fine polish ; fre-

attack, and their severity, especially as affecting' the muscles of the
thorax and abdomen, denoted in general the degree of danger in the
ca<e. The affection is a fixed cramp in the belly of the muscle, which
is g'athered into a hard knot with excruciating pain. In a minute or
two this relaxes ; is agam renewed, or the affection passes to others ;
leaving the miserable sufferer hardly an interval of ease ; and lastly it
passes from one set to another leaving the former free." The remote
cause does not appear clear, nor was the mode of treatment very
effectual. Boniius and Dr. Girdlestone have also noticed this dis-
ease

Gen. XI. Enterouthus. From syTEgof, " intestinum," and Xihi
"lapis." Almost all animals are endued with a power of separating or
secreting lime and other earths from the blood for particular pur-
poses, as that of forming a shell covering in insects and worms, and
of givmg hardness lo the bones in all other animals. Under a mor-
bid action of single organs, or of the sj'stem generally, this is often
secreted in an undue quantity, and poured forth into cavities, where
its accumulation and crystallization must be attended with mischief
Such, at times, is the case in respect to the stomach and intestines.
But independently of concretions derived from this source, we often
meot with others produced by an agglutination or crystallization of
the juices which are contained m the aliment, and which, not unfre-
quputly, give immediate proof of their origin by the aromatic taste,
smell, or other qualities which such concretions exhibit, i here is
also a third species of concretion occasionally to b.? traced in the
inteslinal canal, of a softer structure, and cetaceous or saponaceous
feel, which appears to be produced by a ])cculiar combinalion of ihe
materials of the feces, and constitute pro|)or scybala. although ihis
te. m has not unfrcquently been employed fosigniiy portions of com-
mon feces or slercoraceous matter in an indurated state.

GE. XI.} NOSOLOGY. 41

quently with a metallic lustre on the surface
of each layer; and an accidental nucleus in
the centre : of a spheroidal figure ; chiefly
consisting of vegetable matter.
Bezoar.
Said to be found in the human stomach, but more com-
monly in that of the smaller ruminating quadrupeds, as the

1. Enterolithus Bezoardus. The term bezoardus or bezoar is de-
rived from the Persian cempound Padi-zeher, or Pad-sehr, corrupt-
ed into bedzohr and bezoar : literally " depellens venenum,'' and
hence a direct synonym with the Greek terra Alexipharmic. See
for examples, Sammlung Medicinischer Wahrnebmungen, Band ii.

It is not accurately ascertained that this species has ever been
formed in the human stomach ; for though there are a few assertions
to this effect, the substances to which they refer have not been an-
alyzed with sufficient attention, while the authors appear to use the
term bezoar in a very loose and indefinite sense. The bezoar, as
already observed, is chiefly obtained from the stomach of the smaller
ruminating animals, whose food, from the complexity of the organ,
lies for a long time in nearly a stagnant state, and is compelled to
give forth the whole of its juices under circumstances that afford
them a much easier opportunity of agglutinating or crystallizing than
in many other animals. In the goat kind these balls are called asga-
gropilae. They are of different sizes and figures, the last being
chiefly determined by the nature of the nucleus, which in different
individuals is marcasite, talc, flint, gravel, straw, glass, seeds of
plants, &c. In colour they are white, yellow, or brownish : that of
the gazhat is greenish blue, and when recent highly aromatic. The
most singular circumstance belonging to them is the bronze or me-
tallic lustre that appears on the surface of the different layers, and
does not strike deeper than the surface. This, however, is said to
be a property peculiar to the western bezoar, and seldom or never
to be found in those of the east, which are often of as beautiful a
glossy white as ivory. Daubenton ascribes the gilt appearance to a
vegetable dye fixed by the tartaric acid of the plants in which the
dye exists; and observes, that he has remarked a like appearance
on the grinding teeth of many of the ruminating tribes. Similar
concretions seem at times to be formed out of the animal body, and
as tubercles to the roots or other parts of certain plants: for Four-
croy affirms, that in the cabinet of Jussieu he was shown some curi-
ous bezoars of the oriental appearance, white or yellowish, glossy as
ivory, and of a spheroidal figure, which were said to be produced by
the cocoa.

2. Enterolithus Calculus. This is by no means unfrequently found
in the human stomach and intestines, but far oftener, as observed
above, in the digestive channel of other animals, and particularly w

6

42 JNOSOLOGY. [CL. I.-OR. I.

goat and antelope, particularly the beautiful and elegant
species of antelope denoiniDrtted gazhal by the Arabians
and Persians, and tsebi (*D2i) by the Hebrew poets ; the
ahii of the Turks ; the antelope gaze! of Linneus ; former-
ly employed as a febrifuge and alexipharmic in medicine,
and worn as an amulet by the superstitious, who have

the larger ruminating quadrupeds, or those with the long complicat-
ed digestive organ, where the food, as in the formation of bezoards,
is slowly carried forward ; and in tardy draught horses, particularly
those of millers, which are fed largely on bran, which seems to yield
a ready basis for these concretions. See Phil. Trans, xxiv. 1705,
Thoresby. Id. xliv. 1746, Bailey, id. xlvui. 1754, Watson. In the
last case, the disease had existed for years : the animal died aged
twenty-two, nearly foaling; — but gave no sign of pain or inconve-
nience till three months before her death. The calculus weighed
15 lb. 12 oz.; average diameter 8| inches by 8 inches.

When chemically analyzed, they are chiefly found to consist of a
triple or ammoniaco-magnesian phosphate, like the earthy or white-
sand calculi of the human bladder: though it is difficult to conceive
from what quarter the magnesia is obtained. In the case of millers'
horses, some portion of this earth may perhaps be derived from the
bran, in which it is always to be traced; but the difficulty still re-
mains, with respect to other animals. The figure, whatever be
the size of the calculus, is usually spheroidal, except where broken
into separate fragn^ents : the matter is deposited for the most part,
as in the foimer species, upon a nucleus of some sort or other, as a
small piece of flint, an iron nail, a seed or husk, a piece of hay oi'
straw — the structure sometimes radiating from such common cen-
tre to the surface, and sometimes evincing distinct plates more or less
united to each other. In the human subject these calculi vary from
the size of a pea to that of a tilbert, chesnut, or hen's egg, and are
often still larger. In the case of Margaret Lower (see note on colica
stipatn y) they were usually of the two former sizes, and appear to
have been (brmed in great abundance and with wonderful facility —
for her abdomr-n, upon pressing it, often rattled from the quantity it
contained, with the sound of a bag of marbles. Many of these were
rough and sharp-pointed at the edge, evidently fragments or nodules
of larger concretions, and gave great pain to the rejection, whetn.er
above or below, for they were discharged both ways. The larger-
sized weighed rather morn than two drams; and J)r. Konig, who
relates the case, calculated U)\t the whole that were discharged
during the continuance of the complaint could not amount to less
than 5 lb. avoirduj)()is. In a case related by Mr. Martincaii, Phil.
Trans. Vol. xxxii. year 172.3, live calculi, some of them much larger
than the preceding, were voided per aninn, by a poor woman in
the third month of pregnancy, after having sulfercd from cholic about

xiE. xl] nosology, 43

sometimes purchased a single one at six thousand livres
when very fine, and hired them in Holland and Portugal
on particular occ;isions at a ducat a day.
2. Calculus. Radiating from a common centre, or formed in
concentric layers ; mostly with an accidental
nucleus; more or less porous; spheroidal or
obbng; admitting an imperfect polish ; compos-
ed chiefly of earths and animal matter.

four or five days : of these, the largest, 8 inches in circumference
and Of in length, weighed two ounces sixteen pennyweights and
twelve grains. In this case, and in various others, the calculi seem to
have been in the intestines for a considerable period of time without
inconvenience ; for it is hardly possible to conceive that all these ■
should have been produced in the course of a week. — In another
case in the same journal, Vol. xli. year 1740, related by M. Mackar-
ness, a calculus of this kind was extracted with some difficulty from
the anus by the surgeon who attended, which weighed eight ounces
and a half, and was ten inches and a half in circumference. It is
described as " a hard unequal, ragged tlinly stone," but was not ex-
amined chemically. There is some doubt whether this had not
forced its way from the bladder into the rectum ; but there is little
doubt that it had been present in the one organ or other, and nearly of
its full size, for several years before its extraction ; for the patient's
stools were always obtained with difficulty, and three children, which
she had successively borne in the three preceding years, were all
marked with a large hollow or indentation in some part of the head,
in one instance of sufficient extent to hold the moiety of a small
orange.

In draught-horses and oxen this species of calculus is generally found
single and much larger, and often of little inconvenience for years.
They vary in size from three pounds avoirdupois to ten or twelve.
Of this last weight the author once met with an instance in a horse
belonging to Mr. Hayward, a respectable miller of Brondon
near Sudbury, in Suffolk, and Mr. Watson, Phil. Trans. Vol. xlviii.
year 1754, gives an account of two considerably heavier — the one
weighing fifteen pounds, twelve ounces, with a circumference of
twenty-six inches ; and the other weighing nineteen pounds, exclu-
sive of the outward shell or crust which was broken off in several
pieces, with a circumference of twenty-eight inches. Both these
were laminated, but '•'had the appearance of a pebble;" yet the
specific gravity was much lighter, the first weighing in water not
more than six pounds. At other times the crystallization is more
like that of gneiss or of grit-stone, and almost always light and porous.
See Phil. Trans. Vol. xxxiv. No. 398.

Occasionally however, this species is found gregarious in-stead of

1

44 JifOSOLOGV^. [CL. I.-OR. I.

Intestinal Calculus.
Found in the human stomach and intestines ; but more
frequently in those of the larger ruminating animals, and
slow, heavy draught horses, particularly those of millers.
3. ScYHALUM. Soapy or unctuous ; mostly continuous ; some-
solitary. Mr. Watson, in the article just quoted, mentions a case of
several found in the intestines of a mare, and presented to the Royal
Society by the Duke of Richmond in 1746, the nucleus of two of
which was found to be an iron nail. And by turning to Vol.
xliv. year 174(!, of the same journal, we find these calculi described
by Dr. Bailey, (for the two articles appear to relate to the same case),
as consisting of five in number, of different sizes, some triangular,
and resembling a horse-bean, of an ohve colour and finely polished ;
and one much larger, weighing nearly sixteen ounces troy, and mea-
suring twelve inches by eleven.

3. Scijhalum. SxtiSaAoK, " fimus ;" and especially " fimus induratus."
This species has not hitherto received the degree of attention to
which it is entitled ; and even Fourcroy and Walther seem to have
mistaken it for a biliary calculus. The specific character is drawn
up from various instances that have occurred to the writer, or
have been shown him by others. A laminated scybalum, taken from
the feces of a woman vvlio had long been sulfering from costiveness
and abdominal pain, an inch and a half in length, and nearly two
inches in circumference, of an oblong irregular shape, and reddish
brown colour, was lately presented to a medical meeting in this me-
tropolis as a biliary calculus, the donor expressing his astonishment
that it could by any means be protruded through the ductus com-
munis. It had neither the specific levity, nor the peculiar bitter,
nor the resinous stratification of gall stones; and there can be little
doubt that it was formed in the intestinal canal.

In Sir Everard Home's paper "On the Formation of Fat in the
Intestines of living Animals,'' Phil. Trans, for 1813, a variety of in-
genious facts and experiments are advanced to show the mode in
which scybala are formed in the alvine passage, the component parts
of which Sir Everard supposes to be fat or oil, and mucus. The
same paper contains, in support of this opinion, two interesting
cases by Dr. Bnbington ; the one that of a lady, who, upon taknig
olive oil, constantly voided a number of globular concretions, " va»
ryihg in size from that of a small pea to the bulk of a moderate
grape, of a cream colour and slightly translucent, of a sutlicient
consistence to preserve their form and to bear being cut by a knife,
lik(! soft wax ;" all which, like the scybalum above, had till this
period been reganlcd as gall-stones: the second case that of a girl
four years and a half old, who appears to have had a power of se-
creting oil in the intestines, and of discharging it per anum. "At
three years old her mother observed something come from her as

iL

GE. XII.] NOSOLOGY. 45

times in layers ; spheroidal or oblong ; varying
in colour; consisting chiefly of mucous and ol-
eaginous matter.

GENUS XII.

HELMINTHIA.

Worms or larves of insects inhabiting the stomach or intes-
tines.

she walked across the room, which, when examined, was found to
be fat in a liquid state, which concreted when cold. Ever since
that time to the present she has voided at intervals of ten or four-
teen days the quantity of from one to three ounces, sometimes pure,
at others mixed with feces : when voided, it has an unusually yel-
low tinge, and is quite fluid Uke oil. Her appetite is good, as well
as her spirits, and her flesh firm : her belly rather tumid, but not
hard ; she is subject to occasional griping."

The medical records furnish numerous instances of similar forma-
tions. In the Act. JVat. Cur. Vol. iii. obs. 61, we have a case very
similar to Dr. Babington's, of soapy or oleaginous globules excreted
in a paroxysm of colic : " excreti globuli, quasi saponacei, cedente
dolore hypochondriorum." So, in the Edi7ib. Med. Comment. V. iv.
336, we have a case from the pen of Mr. Scott, of various adipose
masses dejected in a softened state.

Gen. XII. Helminthia. From s;kjtt/vs-v*«f, " lumbricus intestina-
lis," as employed by Hippocrates. See especially his treatise De
Morbis, Lib. IV. entitled nsg« afAivim TrXotrauy. " De lumbricis latis."
The various kinds of worms traced in the human stomach and in-
testines have been diflerently arranged by different writers. Some
have assorted them into round and Jlat worms, and others into indi-
genous and exotic, or those which they tell us are generated in the
alvine canal, and those which enter it from without. The first
method is too limited ; the second hypothetical, for we yet require
proof whether every species found in the canal does not primarily
exist out of it. The present system has, therefore, employed a
different arrangement, and has comprehended under the genus hel-
minthia, or invermination, three species of diseases equally distin-
guished from each other by symptoms, and by the different tribes
of animals that form their remote cause, viz. those which are nour-
ished and find a proper habitation throughout every part of the al-
vine canal j those whose proper habitation is limited to the ex-

^ NOSOLOGY. [CL. l.-OR. h

Helminthia. Arist.

Verminatio. Auct. Lat,

Parasitismus inlestinalis. Young.

Medeud. Arab.

Wurmsucht. G.

Vers. F.

Worms. Invermination.
1. ALVi. Worms existing and finding a proper nidus in the
stomach or alyine canal, chiefly of children and
sickly adults; producing emaciation, a swe:lled
hard belly, gnawing or pungent pain in the sto-
mach, pale countenance, fetid breath, and irrita-
tion of the nostrils.

tretDity of the canal ; and those which have no proper habitation
in any part of it, and enter it erroneously or by accident.

Vermination, however, is a subject that requires yet to be studi-
ed ; and if it be made, as it often has been, to include parasitic ani-
malcules of all sorts, it will be found very difficult to say where it
shall end. In the article Dyscnieria I have observed that that dis-
ease was by the Linnean, and various other schools, ascribed to the
larve of a peculiar insect, which the Swedish naturalist somewhat
too precipitately ventured to introduce into his catalogue, and to de-
nominate acarus dysenteriae. Kircher in like manner has ascribed
thfe plague to animalcules of a particular kind ; Langius the mea-
sles ; various authors the itch, though the question is still doubt-
ful; Sigler petecchiae ; Lusitanus and Poncellus small-pox; Haupt-
man syphilis; Martin and Udman, both pupils of Linneus, elephan-
tiasis ; and Nyander, another pupil of the same great teacher, con-
tagious diseases of most, if not of all kinds, in his paper in the
AmwM Acad, entitled Exanthemata viva. Some, again, have attribut-
ed haemorrhoids to the same source, and others even tooth-ach,
Avhich last opmion seems at one time to have been adopted gene-
rally, for we find Shakspeare making one of his best-drawn char-
acters exclaim

What! sigh for the tooth-ach !
Which is but an humour or a -worm.

And when to these we add the extensive use which has in the pre-
sent day been made of the taenia hydatis, so that almost every lim-
pid cyst, and, according to Dr. Adams, even cancer itself, is nothing
more than an animalcule, (a worm or an insect), it would seem that
three quarters of the diseases (even the most fatal ones) "to which
flesh is heir," result from a saperabundance of vitahty ; and that

GE. XII.] NOSOLOGY. 47*

« Ascaridis lumbricoidis. Head slightly incurved, with a
transverse contraction beneath it: mouth triangular:
body transparent, light yellow, with a faint line down
the side: gregarious and vivacious: from twelve to fif-
teen inches long. Inhabits principally the intestines of

corruption is no longer the triumph of death over life, but of life
over itself; of life in one form over life in another

We are at length approaching to more sol)riet_)' in our inquiries,
and it is high time that such a period should arrive ; for we were in
great danger of running into the wildest fancies of equivocal gene-
ration, and of equally relinquishing all principles and all limits in
natural history. Iristead of a new succession of living beings per-
petually but fortuitously produced by a mere bildungsirieb (as the
Germans denominate it), a simple formative effort of the vital pow-
er under peculiar circumstances, it is more than probable that there
is no worm or insect, no animalcule of any kind, that can be proved
to exist in man or any of the larger animals, but might he traced,
if due attention were paid to the subject, to exist out of them, un-
der the form of eggs, larves, or some other modification, and to
descend in as regular a chain of succession as man himself

The common round worm (ascaris lumbricoides), though the in-
testines form a proper repository for it, does not exist in the intes-
tines alone. Lister affirms that he has seen them in great numbers,
in ulcers on the surface of the body, in which doubtless the parent
insect or other animal had deposited her ova. Phil. Trans. Vol.
viii. year 1673. In his natural history of the sheep, Palmeerus has
rendered it at least probable that the fasciolai hepatica;, or flukes,
found so abundantly in the liver of quadrupeds of this kind that die
of the rot, and the origin of which has so much puzzled the natur-
alists, are swallowed by the animal in marsh or stagnant waters.
Amctn. Academ. iv. 58. And Linneus himself pointed out that the
tainias or tape-worms, the existence of which in the intestinal canal
has been an equal source of difficulty to the physiological inquirer,
exist, though much smaller, in muddy springs; and notwithstand-
ing that Pallas, at first, expressed doubts upon this point, the asser-
tion has been adequately confirmed by subsequent observations.
See Dubois^ Amoen. Acad. De Taenia ii. 20.

Plants are generally subject to the same disease, and suffer in
the same manner ; for the usual effects are atrophy and emaciation ;
of vvhich we have a very striking and common example in the
blight or white mildew {ulblgo,) rust or red mildew (?'i/6?go,) and smut
or black mildew {ustilago,) whether of wheat or other grains, which
are now well ascertained to be produced, not indeed by worms,
but by the growth of minute fimguses or other cryptogamic para-
sites on the leaves, stems, and glumes of the plant affected; the
chief of which are the mucor erisiphe, m. granulosus, aacidium cor-

48 NOSOLOGY. [CL. I.-OR. I,

thin persons, generally about the ileum, but sometimes
ascends into the stomach, and creeps out of the mouth
and nostrils : occasionally travels to the rectum, and
passes away at the anus.

Ascaris lumbricoides. Linn, Turton. Hooper,

Lumbricus teres. Baillie, F. iv. 9. Auct. Far,

Long round worm.
C Trichocephali. Body above slightly crenate, beneath
smooth; finely striate on the fore-part : head obtuse and
furnished with a slender retractile proboscis ; tail or
thinner part twice as long as the thicker, terminating
in a fine hair-like point : about two inches long ; in co-
lour resembles the maw-w^orm or common ascaris : gre-
garious, and found chiefly in the intestines of sickly
children ; generally in the caecum.

Trichocephalus. Linn. Turt.

Trichuris. Bail. F. iv. 9. Hoop.

Long thread-worm.
y Taeniae Solii. Articulations long and narrow, with mar-
ginal pores by which it attaches itself to the intestines,
one on each joint, generally alternate ; ovaries arbo-
rescent: head with a terminal mouth surrounded with
two rows of radiate hooks or holders; and a little
below, on the flattened surface, four tuberculate orifices

nutum, uredo frumenti, and u. segetum of Linneus. See Sir Jo-
seph Banks's valuable essay on this subject, published in 1805, with
engravings giving various, and some of them highly magnified re-
presentations of the wheat-straw when infected with this disease.
Some of these parasites have a peculiar fondness for tlie barberry-
tree (berberis vulgaris,) where the seeds are produced in great
abundance ; and it has hence often been found, that where a large
barberry tree is planted in the vicinity of a wheat field, the wheat
nearest to it is affected with mildew of some sort or other.

Grasses are also subject to the same disease, and particularly the
poa aquatica. See Sowei-by''s English Fungi, Vol. ii. tab. 139, and
for wheat, tab. 140; and compare with Fnntana's Osservazioni so-
pra la Ruggine del Grano. laicca, 1767. 8vo.

Yet it is not merely by parasitic plants, but by worms themselves,
that vegetables are often infested, debilitated, and at times destroy-
ed. Stems, leaves, and fruits, are all attacked in their turn; and
occasionally the stem of the stoutest tree is eaten through, and death
ensues: of which we have frequent examples in the willow (salix
a?6a,) horse chesnut (a^sculus hlppocastanum,) as also in the typha
lati/olia. See Willdenow, Physiol. Veget. cliap. vi. § 323.

GE. XIl.j NOSOLOGY. 49

or suckers, two on each side: tail terminated by a
semicircular joint without any aperture: from thirty to
forty feet long, and has been found sixty. Inhabits the
intestines of mankind generally at the upper part, where
it feeds on the chj'lc and juices already animalized. Is
sometimes solitary, but commonly in considerable num-
bers; and adheres so firmly to the intestines that it is
removed with great difficulty.
Taenia solium. Linn. Turl. Bail.
Taenia osculis marginalibus. Hoo^.
Lvng tape-ioorm.
3 Taeniae vulgaris. Articulations short and broad, with a
pore in the centre of each joint, and stellate ovaries
round them : body broader in the middle, and tapering
towards both ends; head resembling the last, but nar-
rower and smaller ; tail ending in a rounded joint.
Like the last inhabits the upper part of the intestines,
and feeds on the chyle ; from three to fifteen feet long ;
usually in families of three or four.
Taenia vulgaris. Linn. Txirt.
Taenia lata. Baill. F. iv. 9.
Taenia osculis superficialibus. Hoop.
Broad tape-worm.

Two other species of taenia are found in other ani-
mals, chiefly carnivorous cjuadrupcds: t. lata and t.
dentata, the former with a central pore, the latter
with one at each edge.
« Fasciolae. Body flattish, with an aperture or pore at
the head, and generally another beneath : intestines
flexuous : ovaries lateral : hermaphrodite, and ovipa-
rous.
Fluke. Gourd-worm.
2. PoDicis. Worms, or the larves of insects existing, and find-
ing a proper nidus within the verge of the anus,
exciting a troublesome local irritation, sometimes
accompanied with tumour; frequently preventing
sleep, and producing pain or faintness in the sto-
mach.
K Ascaridis vermicularis. Head subulate, nodose, and di-
vided into three vesicles, in the middle of each of
which is an aperture by which it receives nourish-
ment ; skin at the sides of the body finely crenate
or wrinkled ; tail finely tapering and terminating in a
point ; the female has a small punctiform aperture a
7

50 NOSOLOGY. [CL. l.-OR. T.

little below the head, through which it receives nour-
ishment. Gregarious ; viviparous ; about half an inch
long; sonietimes wanders into the intestines, and oc-
casionally as high as the stomach.
Ascaris. BailL F. iv. 9.
Ascaris vermicularis. Linn. Turt. Hoop.
Maw-worm. Tliread-worm.
C Scarabaei. Larves of several species of the heeth.

These have not been accurately described. Per-
haps the following are the chief: grey larve, with
yellowish legs and ferruginous head, of s. nobilis ;
and those of s. Schoefl'eri and s. volvens, which, when
out of the body, deposit their eggs in round balls of
animal dung, which they roll up and bury with their
hind feet.
y (Estri. Bots, or larves of the hemorrhoidal breeze or gad-
fly. Round ; pale-green ; tail obtusely truncate ; head
tapering; mouth horny, with two lips, and two recur-
ved black claws on each side of the mouth. Found
convoluted in the mucus and feces of man, but far more
frequently of other animals, and especially of the horse.
3. ERRATicA. Worms introduced by accident, and without
finding a proper habit:Uion in the stomach or

3. S H. erratica Hirudinis. Dr. Lister, apparently without know-
ing that the subject had been touched on before, describes the case
of a patient, who, after having "had about his stomach and right
side a most exquisite and tormenting pain for at least four months,
which many times threw him into horrors and chillness, ague-Hke,
and was the sickest man," continues he, " I ever saw not to die,"
vomited up a worm of a dark-green colour, like a horse-leech, and
spotted. From the puncture of the animal, or the violence of the
retching, he brought up at the same time two pounds of coagulated
blood : and had occasionally discharged blood downwards. The
man imagined he drank it in pond water during the preceding sum-
mer. The worm was dead when rejected, or at least before Dr.
Lister saw it: four inches long, and three in its largest circumfer-
ence : and is still farther described and drawn as having three small
fins on each side near the head, with a forky, finny, transparent,
and extensile tail. Phil. Trans. 1681-2. No. 6.

One of the most extraordinary cases, among those entitled to at-
tention, is related by Mr. Paislexj in the Edinburgh Medical Essays,
ii. art. 2G. In this case there were two worms, whose heads he
compares to that of the horse-leech, and which appear to have been
tolerably quiescent in their growth, till the general system was dis-
turbed by a wound on the breast received by the patient in conse-

GE. XII.] NOSOLOGY. 51

intestines : producing spasmodic colic with se-
vere gripings; and occasionally vomiting or
dejection of blood.
Of this subdivision we know but little : yet the ensuing
instances may afford sufficient reason for forming it. It
might easily be enlarged, but the authorities for extending
it further are doubtful.
ei Gordii. Hair-worm, or seta equina. Found in soft stag-
nant waters: from four to six inches long, twisted into va-
rious knots and contortions : colour pale brown, with dark
extremities.

This disease is most frequent among the peasants of
Lapland, and was suspected by Linneus, and has been
since proved, or thought to be proved, by Dr. Montin, one
of his most celebrated disciples, to be occasioned by their
drinking the half-putrid water of stagnant marshes or
ditches inhabited by the gordius. It is not known on the
Lapland mountains. The gripings are often so violent,
that the patient rolls and writhes on the ground in severer
agony than a woman in labour, and discharges bloody
urine. After many hours, sometimes an entire day, the
disorder terminates in a profuse ptyalism that continues for
a quarter of an hour. The Laplanders call the disease
Ullen, or Hotme. Linn. Flor. Lap. de Angelica. Montin,
Amoen. Acad. Splachnum. ii. 26.

quence of a duel with the smalt sword. The general symptoms of
this species of helminthia appeared about the third day afterwards,
and continued with many variations for several weeks, when the
patient discharged inferiorly one of these worms, measuring a foot
and a half in length, and an inch and a half in diameter, dead, but
full of blood, and accompanied by a large dejection of grumous
blood, " to appearance some pounds ;" and not many weeks after-
wards the other still larger. — A worm, apparently similar, is stated
by Dr. Bond of Philadelphia, 1754, to have been discharged down-
wards by a female patient of his, who had been long subject to an
hepatic disease, which gradually changed to violent helminthic
symptoms in the stomach. These, at length, suddenly vanished,
and within twenty-four hours the worm was dejected, dead, and in
two parts, the whole making twenty inches in length. The patient
died soon after; and on opening her, this worm appears to have
worked its way, when small, into the liver by the course of the
common duct, to have committed great depredation here, and after-
wards, with considerable difficulty and dilation of the duct, to have
travelled back again. Dr. Bond ventures to call it an hepatic leech ;

•'i2 NOSOLOGY. [CL. I.-OR. I.

Colica Lapponica. Sauv. ii. 103.

€ Hirudinis. Various species of the leech. Swallowed along
with the muddy and stagnant water they inhabit.

Apparently hoth the medicinal and the horse-leech (h.
sanguisuga) have been thus found ; but the exact species
has not been sufficiently indicated. Sau\ ages, in his ge-
nus Hasmatemesis, quotes Galen, Schenck, and Wedel,
but does not describe the species. Upon turning to Galen,
iv. 411. D. the reader will lind that he briefly adverts to
the disease, and quotes from Asclepiades and ApoUonius
the remedies that were employed in their respective days :
but he does not characterize the worm.

y Muscas cibariae. Larves of the pantry-fy. These seem
chiefly to produce mischief while in the stomach, into
which they may be taken with decayed cheese, as the
eggs arc sometimes deposited in it. See Dr. White's case,
Mem. Med. Soc. Lond. Vol. ii. The patient, aged
thirty, was emaciated, of a sallow complexion ; had grip-
ings and tenderness of the abdomen ; costiveness, rigors
and cold extremities. Took columbo root, and occasion-
ally calomel and other purgatives. In a month was bet-
ter, and the appetite good. The next purgative brought
away an immense number of pupes or chrysalid worms;
some of which being preserved, were transformed into
four-winged insects, the musca cibaria.

though he calculates its course as now stated. — London Med. Observ.
and Inq. i. 68.

Maroja, physician to Philip IV. of Spain, in his treatise DeMorbis
Internis, hb. 4. cap. 16, mentions the case of a patient who discharg-
ed a still larger dead round worm, of the same monstrous kind, and
died in the act of discharging it : its length was twenty fingers
breadth ; its rotundity equal to the size of a stout man's hand : full
of blood, and had more than a pound and a half of blood taken from
its inside.

3. H. crratica Musca. cibaria. — Mr. Church, to whose entomologi-
cal skill these worms were confided, asserts in the same paper, that
he once knew a child discharge a larve of the caddy insect (phry-
ganea grandis) ; and that the phalsena pinguinalis lives and is nour-
ished in the stomach ; and after sustaining several metamorphoses
is thrown out, and proves its proper genus. See also Mr. Calder-
wood's case. Edin. Med. Com. ix. 223.

GE. XIII.] NOSOLOGY. 53

GENUS XIII.

PROCTICA.

Pain or derangement about the anus, without primary inflam-
mation.
Proctica. Linn. 59. Vog. 167.

1. SIMPLEX. Simple pain at the anus.

Proctalgia. Auct. var.
Douleur du fondement. F.

2. Callosa. Pain produced by, or accompanied with, a cal-

lous contraction of the rectum.
The cause is usually, though not always, scirrhus ; and
colica callosa is an occasional result. See Colica, spec. 6.
The schirrhus, as in other cases, sometimes degenerates
into carcinoma.

3. Tenesmus. Painful and perpetual urgency to go to stool,

with dejection of mucus alone, and in small

quantity.
Tenesmus spontaneus. Sauv.
Obstipatio Tenesmus. Young.

Gen. XIII. Proctica. From ^gawraj, podex, nates. The term
is taken from Linneus. and employed nearly in a parallel significa-
tion. Sagar and Macbride, from the same root, have formed proc-
talgia.

4. Proctica Marisca. There has been much difficulty felt among
the methodical nosologists in arranging this species, in consequence
of the diversity of its symptoms Sauvages and Sagar have express-
ed a desire to limit the term haeraorrhois to an occasional and free
flux of blood from the anus ; and to make a distinct genus of haemorr-
hoidal tumours under the name of marisca: hence the first occurs
as a separate disease in their respective systems under the class
Jluxus, order alvi-Jiuxus ; and the second under the class vitia^ order
cystides. Cullen, contemplating piles and ha;morrhoidal flux as the
same, and invariably a constitutional disease accompanied with fever,
has placed it under the class pyrexia, order hcEinorr ha giw. la both
these views, however, he seems to be nearly alone most other pa-
thologists regarding piles or haemorrhoidal tumours as a local affec-
tion, and perhaps no others contemplating them as necessarily con-
nected with fever. There is, moreover, a laughable kind of sole-
cism, in applying the term hcemorrhois, literally " flux of blood,'' to
a disease, one of whose subdivisions admits of no flux whatever, and
another of a flux of mucus without blood.

54

NOSOLOGY. [cL. I.— OR. 1.

Stuhlzwang. G,
E'preinte. F.
Straining.

Occasionally arising from local acrimony or irritation :
and then an idiopathic affection.

Found also as a symptom in various other complaints,
as dysentery, haemorrhoids, helminthia, costiveness, calcu-
lus of the bladder, and pregnancy.
4. Marisca. Livid and painful tubercles or excrescences, usu-
ally with a discharge of mucus or blood.
Marisca. Sauv. Sag. Plouquet.
Haemorrhois. Cull.
Proctalgia haemorrhoidalis. Machr,
Busyr, Arab.
Guldene ader. G,
Hemorrhoi'de. F.
' Piles.

tc Cseca, Pain and tubercles without discharge.

Hffimorrhois cosca. Cull.

Blind piles.
C Mucosa. Tubercles pale and mucous.

Haemorrhagia mucosa. Cull.

Leucorrhois. Vog.
V Cruenta. Tubercles florid and bleeding.

Haemorrhagia cruenta. Cull.

Haemorrhois. Linn.

Bleeding piles.

On these accounts I have followed Sauvag'es and Sagar, rather
than Cullen, in making a distinction between the two affections of
anal tumours or tubercles, and anal haemorrhage : and have trans-
ferred the latter to the genus haemorrhagia in Class III. Order
iV. — The position and definition of haemorrhois, as given by Linneus,
range nearly parallel with that of Sauvages ; for it occurs in his
class evacuatorii^ order abdominis^ and is expressed " dejectio sangui-
nis cum proctica absque colica :" by proctica, meaning the general
anal affection to which the term is applied in Ihe present system.
Parr, like the preceding writers, separates hasmorrhois from fevers,
bat with Cullen employs the term to import anal flux of blood, and
anal tumours. In him it occurs in the order profluvia, genus hsB-
morrhagia ; and consequently he falls into the solecism just noticed
in Cullen's use of the term. Crichton has omitted the disease alto-
gether, unless he intends to include it, of which his table gives no
notice, under htEmatorrh?pa arteriosa, which he explains arterial
haemorrhage from the intestines ; but which, after all, could only
comprehend a very few of its modifications.

GE. XIII.] NOSOLOGY. 55

i Polyposa. Polype-like excrescences shooting from a
slender root; bulbous; soft and compressible; red or
reddish ; chiefly internal.

Found, also, in some one of the varieties, occasion-
ally, as a symptom or seqac.l of parabysma, gout,
asthma, sciatica, rheumatism, various affections of
the bladder, hypocondriasis, hysteria, ecphronia ; and
occasionally giving rise to recent or fistulous ulcers.
5. ExANiA. Inversion and prolapse of the villous tunic of the
rectum, from relaxatioli of the sphincter, with
more or less tumour.

Exania. Sauv. Sag. Plouquet.

Proctocele. Pathol. Med.

Haemorrhois procedens. Cull.

Haemorrhois ab exania. Sauv.

Prolapsus ani. Plater. Nenttr.

Gesassfall. G.

Chute du fondement. F.

Falling down of the fundament.

X Simplex. The tumour of moderate size, and the reduc-
tion easy.

C Spasmodica. The tumour large and irritated ; and the
intestine contracted by a spasm of the sphincter.

The tumour has, in the last case, been frequently
mistaken for a marisca ; and Dr. CuUen has, per-
haps, given some countenance to the error by de-
scribing one of his species of haemorrhois as pro-
duced by a prolapse of the anus. The haemorrhoidal
tumour is dull and livid ; that from a prolapse of the
anus is flesh-coloured, sometimes wrinkled, at others
smooth and shining.

In some instances the prolapse is so considerable
as to render visible the valvulae of the colon. Mor-
gagn. De Sed. et Cans, Morb. Ep. xxxiii. Ixv.

Found, also, as an effect, in obstinate costiveness,
stone in the bladder, labour, and helminthia podicis.

56

NOSOLOGY. [CL. I.-OR. II.

ORDER II.

SPLANCHNICA.

AFFECTING THE COLLATITIOUS VISCERA.

Disquiet, or diseased action in the organs auxiliary to the
digestive process, without primary inflammation.

GENUS I.

ICTERUS.

Yellowness of the eyes and skin ; white feces ; urine saf-
fron coloured, and communicating a saffron dye : the
course of the bile obstructed.

Order II. Splanchnica. IL-xTMyy^nKit^ " Visceralia," " ad viscera
pertinentia." So Dioscor. i. cap. b2, <rTAay;^j»/x« ^u^ftxKx, " visce-
rales medicinae." Splanchna, in its greatest latitude in modern
times, comprises, like the Latin viscera, all the larger bowels or
internal organs, to whatever cavity they appertain, and consequently
includes the brain. But, agreeably to its more exact sense, it was
formerly limited to those of the upper and lower belly, the entrails,
as they are colloquially denominated, those more especially which
were consulted by the aruspices, and constituted the chief parts of
the sacrifice. In this sense it is used by Homer in describing the
sacred feast made in behalf of Telemachus when on the point of
quitting Ithica. Odys. lii. 5.

AtiT«g iTTic xxTx jtMig iKxv). Kxi SJlAArXN^ ea-«ff'«»T«, &c.

Gen. I. ICTERUS. " i»«g«5 .•'"' among liie Romans " Morbus regius,"
or ' aurigo,'' on account of its golden hue. The lexicographers
have not been able to follow up the term to its origin. The author
ventures therefore to suggest that it is probably derived from the
Hebrew li^D, with a formation ■• producing I/ID^, (icter) and im-
porting as a verb, " to surround," " circumfuse," *■' encompass;" and
as a noun " a royal crown or golden diadem.'''' Icterus was a term
also given to the golden thrush, on account of its yellow plumage ;
and hence the bird was fabled to be connected with the disease ;
and it was believed, according to Pliny, that if a person labouring

GE. I.] NOSOLOGY. 57

Icterus, ^uct. Groec.
Morbus regius. Aucl. Lat.
Icterus. Lin. Vog, Boerh. Cull.
Auriii;o. Sauv. Sag.
Cachexia icterica. Hoffm.
Ciiolelithia icterus. Young.
Yerekaun. Arab.
Gelhsucht. G.
Jaunisse. /c/erejaune. F.
Jaundice.

1. CHOLffius. The course of the bile obstructed from its own

viscidity : general languor ; nausea ; dyspep-
sy ; and occasional pain or uneasiness at the
stomach.

Aurigo ab obstructione. Sauv.

Icterus biliosus. Parr. Diet, art. J^osol.

2. cHOLOLiTHicus. The course of the bile obstructed from

bilious concretions in the ducts, at length
protruded and discharged with the feces;
frequent retching ; acute pain in the hy-
pogastric region, increased upon eating.

under the jaundice looks at the pheasant, the bird dies and the pa-
tient recovers.

This complaint, from Saiivages to Culien, has generally been
ranked among the cachexies or depraved habits ; '■''habitus deprava-
^MJ," as Dr. Culien explains the class. Vet one of the species ad-
mitted by both these writers is that of infants produced a few days
after birth, and ceasing almost as rpidly; while another is the
mere result of the mechanical obstruction of the ductus choledo-
chus by local concretions. Yet it would be difficult to say in what
other part of the systems of these and various other writers this
disease should find a place. Parr puts it more correctly under the
suppressorii ; and Dr. Young under the pareccrises ; which, in a wide
but allowable latitude of the term, may include all the species ex-
cept the spasmodic^ perhaps the most doubtful of the whole, in which
light indeed he regwrds it himself.

The pain is greatest in species 2. i. chololithicus : the general
functions are, perhaps, most deranged under species 1. i. choloeus,
(x.<>xatoi) in which there is not only obstruction but depravation of
bile; and in species 4, i. hepaticus, in which it is not only perhaps
secreted in too small a quantity, but at the same time imperfectly.
A German physician of the present day, of high and deserved re-
pute, Gothlieb Richter, (Med. and Chirurg. Observations) conceives
that this is not only the severest but the most common cause ; and
8

58 NOSOLOGY. [CL. I.-OR. II.

Icterus calculosus. Cull.
Aurigo calcuiosa. Smiv.

3. sPASMODicus. The course of the bile obstructed by spasmo-

dic contraction of the bile-ducts : the dis-
ease preceded by acrimonious ingesta ;
hysteria, or some violent passion of the
mind ; and voluntarily subsiding within a
few days after these are removed.

Icterus spasmodicus. Cull.

Aurigo spasmodica. — a. a venenis. Saiiv.

4. HEPATicus. The course of the bile obstructed by the de-

rangement of the liver from scirrhus or in-
farction : occasional retchings and dyspepsy.

Icterus hepaticus. Cull.

Aurigo hepatica. Sauv.

5. INFANTUM. The course of the bile obstructed by viscid me-

conium ; without pain or dyspepsy : easily re-
moved by purgatives.

Icterus infantum. Cull.

Aurigo neophytorum. Sauv.

in proof of its depending entirely upon a morbid state of the liver,
adverts to a case in which there was no gall-bladder to be found,
and only a skinny substance in its stead without cavity at all ; in
Avhich instance he supposes the bile, however imperfect, to have
been absorbed by the morbid irritation of the liver as soon as it
was formed. Yet its presence in the blood is, perhaps, not more
unsalutary than its absence from the stomach and alimentary canal.

On what account Dr. Cuilen has omitted spec. 1, i. choloeus it is
not easy to say. It is noticed by most practitioners from Hippocra-
tes to the neoterics. Parr's name of biliosus the author would have
adopted, but that this term is usually employed in a different sense,
as importing redundancy and activity, rather than morbid change in
its combination : independently of which the Greek term is nearly
as common as the Latin, and gives rise to all our compounds. Dr.
Young expressly includes this species under his cholelithia icterus,
synonymous with spec. 2 of tbe present arrangement : but the
symptoms are different, and the name cannot accurately cover it.

The icterus gravidarum of Cnllen and others is here omitted, as
unquestionably not an idiopathic disease, but a symptomatic affection
only.

Cullen has justly observed, in a note subjoiiied to this genus, that
yellovvness of the skin may proceed not merely from resorbed bile,
but from effused blood, or serum of blood, as we see perpetually in
eccbymosis. The saffron dye in the urine is perhaps the truest pa-
thognomic.

GEN. II.] NOSOLOGY. 59

Found also symptoniatically in pregnancy, colic, and
fevers of various kinds : especially epanetus icterodes, or
yellow fever.

G E N U S II.

MELiENA.

The colour of the eyes and skin fuliginous, leaden or
livid; black, viscid dejections, with occasional vomi-
tings of the same; anxiety; depression of spirits.
Melaena. Sauv. Plouquet. CulL Catal. Morb. Omiss.
Melasicterus. Sag.
Cholirica. Guarinoni. Linn.
Melaena morbus (MeXa«»« Nat/o-e?.) Hippocr.
Zeryr. Arab.
Schwartze-galle. G.

Maladie noire. Iclere noire. F. '

Black vomit. Black jaundice;
1. CHOLCEA. The black discharge bilious ; the vomiting occa-
sionally green and acid ; great languor ; ver-
tisfo.

Gen. 11. MEr,a:NA. MiXxtux, from ^eA<»;, " niger." This disease
is not in Dr. CuUen's arrangement ; but it occurs under the present
name, in his subjoined '•'Catalogue of omitted diseases, which per-
haps ought not to have been omitted." Catalogns morborum a nobis
omissorum, quos omisisse fortassis non oportebat. Hippocrates is pe-
culiarly full in his description of this disorder, and there ai-e few no-
sologists who have not entered it into their respective systems. The
species and definitions in the present arrangement are taken from
Hippocrates, de Morbis., lib. ii. with little change. The first seems
to depend upon an organic depravation of the liver, chiefly perhaps
in the case of habitual gluttons and drunkards, who have paralyzed
or worn it out by perpetual stimulation : in consequence of which
a pitchy and flaky bile is secreted instead of the genuine and heal-
thy fluid. The second is probably the result of active or pasr
sive haemorrhage (most likely the latter) from the liver, the spleen,
or both in a state of physcony. The function of these organs appears
to be one and the same ; the blood in both is pecuharly carbonated,
as the colour sufliciently indicates, and the closest alliance subsists
between them ; on which account Hippocrates calls the spleen the
left liver, and Aristotle the bastardliyer. The spleen has sometimes
been found adhering to the liver.

00 NOSOLOGY. [CL. I.-OR. II.

Melaena atrabilis. Sauv.
2. CRUENIA. The discharge consisting of grumous blood in-
termixed w ith bile : pungent, tensive pain in
both hypochondria ; compressive pain at the
pit of the stomach and fainting.
Melaena splenetica. Sauv.

The stomach and intestines full of sanguineous matter.
Columb De Re Anat. Haller, Bib. Med. part ii. p.
125.
Has sometimes proved salutary. Haller, Nov. Comment.

■ Goett. viii. p. 2.
Sometimes periodical. De Passis, in Blegny Templed'
Esculape, 1680.

GKNUS III.

CHOLOLITHUS

Pain about the region of the liver, catenating with pain at
the pit of the stomach : the pulse unchanged ; sickness ;

Gen. III. Chololithus. From j^«A)i, or pijoAov bile, and /<d»j, a stone.
This disease has been confounded with icterus by most of the noso-
logists, but improperly so, for the yellow dye of the skin and urine,
which is the pathognomic symptom of jaundice, occurs often with-
out chololithus, and chololithus even in its passing species or acute
state, without the yellow dye. Dr. Young makes it indeed a distinct
genus, but regards icterus as one of its species. After Plouquet he
spells it cholelithia, who probably took the term choledochus as
Lis example. Either is allowable : chololithus is here preferred
as in unison with enterolithus, and the usual mode of forming Greek
compounds.

The symptoms of the first species are often not very distinct, for
when the gall-bladder has been slowly enlarged, a concretion, as
bulky as a pullet's egg, has sometimes lodged in it, and occupied the
entire cavity, without any very great derangement of the general
health.

W hether the gall-bladder be a mere receptacle for superabun-
dant bile secreted by the liver, or whether it add any new secre-
tion to thai deposited in it, is a question which has been long agitatr
ed by physiologists, and is by no means settled at the present mo-
m-'-nt. If is a curioiis fact however, and which should seem to be
nearly decisive of the question, that in most, perhaps in all, cases,

©EN. 111.] NOSOLOGY. 61

dyspepsj ; inactivity : bilious concretion in the gall-
bladder or bile-ducts.

Cholelithus. Plouquet.

Cholelithia. Young.

GalLstein. G.

Pierre au fiel. F.

Gall-stone.
1. QUiEscENS. Pain about the liver and at the pit of the sto-

the hepatic bile, or that secreted by thp liver, is mild and sweet be-
fore its introduction into the cyst, and consequently becomes bitter
only from being operated upon while in this situation : and it is
from this circumstance that the first or quiescent species discovers
itself, perhaps chiefly by a less pungent and bitter taste in the mix-
ed or general bile than commonly belongs to it ; for the gall-blad-
der, being nearly plugged up, or impeded in its function, is incapa-
ble of exerting its proper activity; and hence, too, the irregularity
in the alvine discharges, even where no considerable degree of pain
is felt about the region of the liver, and the stomach is not very
sensibly affected. Dr. Bush ascribes this production of bitter taste
to a putrefactive process which takes place in the bile after its re-
ception into the gall-bladder : but this is no place to pursue the sub-
ject. It is singular to observe, that in herbivorous animals desti-
tute of a gall-hladder, as the horse, elephant, manate, camel, rat,
rhinoceros, as also in several of the cetaceous tribes, the bile is still
possessed of a bitter principle ; and it is perhaps still more singular
that we meet with this secretion and this principle in larger abun-
dance, proportionably to the size of the animal, in various insects
that have neither liver nor gall-bladder, than in mammals of any
kind; of which the curculio nucum, or nut-weevil, furnishes us with
a familiar example ; for every one must have seen with surprise
the extent to which the larve of this curious little insect, found so
frequently in the fruit of the hazel, is capable of embittering the
taste of the nut, and of giving a yellowish brown tinge to its white-
ness, which alone proceeds from the bile with which its feces are
loaded.

It is possible that minute biliary concretions may occasionally be
formed in the hepatic pores; but the absorption of the more sub-
tile parts of the bile which must necessarily take palce in the gall-
bladder, from its quiescent state, must dispose it in a much greater
decree to assume a concrete form, the structure of which varies,
though it seems to evince a general tendency to crystallized rays
in the center, with concentric laminae towards the surface. See
Baillie Morbid Anatomy, F. v. PI. vi. p. 109-113.

Berzelius has lately shown that neither the resin nor the albumen,
which have been so g^merally ascribed to bile, have any existence
in it. The bile becomes resinous only m the process of experi-

^2 NOSOLOGY. [CL. I.-OR. 11.

mach obtuse and occasional : and bile less bit-
ter than usual : the dejections irregular.
2. MEANS. Pain about'the liver acute; frequent vomitings ; de-
jections white ; and at length loaded with one or
more bilious concretions.
Cholelithia acuta. Young.
Passing of gall-stones.

The German physicians trust chieflj to sulphuric ether
' and oil of turpentine in conjunction. See Dumnde Obser-
vations sur I'EfFicacite du Melange, &c. 1791.

GENUS lY.
PARABYSiMA.

Knotty or unequal intumescence of the abdomen from an

ment, by supersaturating it with acids, while the material hitherto
regarded as albumen, appears to be nothing more than a small por-
tion of mucus furnished it from the gall-bladder. M. Berzelius ob-
serves, however, that it acquires an increased tendency to form re-
sin with the acids, in proportion to the length of time it has remain-
ed in this depository. It possesses, says he, the same properties of
alkali and salts as the blood ; and contains a peculiar matter of a
bitter and afterwards sweet taste, which evinces characters in com-
mon with the (ibrin, the colouring matter, and the albumen of the
blood, from which it is formed in tlie liver. View of the Progress and
Present Stale of Anviial Cheinisinj : translated from the Swedish by
Gustavus Brunnntark, D. D. In the hystrix cristala, or crested por-
cupine, bilious concretions appear to be more common than in any
other animal: they are for the most part closely crystallized; and
have been called bezoars by physiologists vvho ought to have known
the difference. They have neither the metallic lustre of the west-
ern, nor the aroma of the eastern bezoar, while they contain the
tinge and bitter of the bile.

Gkn. IV. Parabysma. Ua.^u.^vcrfi.x.1 " id quod magnis sarcinis infar-
citur,"' from -^eufx/iva), " male coacervo, or infarcio." The author
has adopted this term from the Greek writers instead of einphraxis^
hyposarca or physcoiiia., because the two first, which, however, have
not been very generally employed, are too limited for the purpose,
and consequently calculated to convey erroneous ideas ; "while the
last has been used so generally as to convey no definite idea what-
ever.

GE. IT.] NOSOLOGY. 63

indurated enlargement of one or more of the viscera
contribiUorj to the digestive function ; derangement
of the general health.
Physconia. Cnsson. Sauv. Cull, et alior.

Physconia was, perhaps, first made choice of by Cusson as a
generic name to comprise a variety of organic tumours, of origins,
positions, and properties so different as to defy all generic definition
whatever. Sauvages, however, has followed him, and even added
to the number of his species; and CuUen has followed Sauvages.
In Sauvages it it extended to every kind of intumescence of the
solid parts of the abdomen without pregnancy or fluctuation. '' Ib-
tumescentia abdominis a partibus solidis, sine graviditate, et tiuctua-
tione." Cullen does not essentially deviate from this character;
in like manner expressly limiting it to the abdomen. Yet in both
we have, among the list of affections, a physconia renalis ; various
external physconies, and a physconia ab excrescentia, while abdomi-
nal fatness or corpulency is made another species. Yet the scope
of physconia is carried still wider by Dr. Young, who omits all limi-
tation, extends the term to softish glandular tumours in any part of
the body, and ranks under it simple bubo, bronchocele, sarcocele,
and various pulmonary enlargements ; at the same time making
physconia, thus extensive in its range, a mere species of a genus
which he calls ecphyma, and which he defines " a solid tumour not
acutely jiainful."

It has been found in no small degree difficult to characterize the
meaning of a physcony. The term itself gives us little or no clue :
for ^voKMDitc simply imports inflation, or a collection of wind, as in
an inflated bladder. Dr. Young, as just observed, makes it a species
of ecphyma, or so/id tumour; yet, in his specific definition, he de-
scribes it as " a general softish tumour of a viscus or gland, com-
pletely occupying a considerable part of its substance." Sagar, on
the contrary, defines it to be a tumour ^'- hard to the touch, resisting
without fluctuation or elasticity," nnejluctuatione, et elasi, ad tuctnm
dura, resistens: while Turton explains it " a hardish tumour, occupy-
ing one or more of the abdominal organs, and resembling a bladder
distended with wind."

Physconia, therefore, by importing every thing, imports nothing
definitely: and is made to embrace diseases that have no analogy in
origin, situation, symptoms, or mode of cure. Dr. Cullen, while he
retained the term in its general and indefinite range, was sufiiciently
sensible of its looseness, and only retained it from want of time to
be more accurate : " species sequentcs," says he, in a note subjoin-
ed to the genus in the sixth edition of his Synopsis, '■'■ ncqnaquam ad
normam JS'osologioi method icce recensentur; sed accuratius Physconije
species indicare difficile foret, saltern plus exegisset, quam quo nunc
fruor otii."

64

NOSOLOGY. [cL. I.-OR. 11.

Ecphjma physconia. Young,

Hjposarca. Linn.

Emphj'actica. Haller. Tulp.
1. HEPATicuM. Hard tumour in the right hjpocondrium, verg-
ing towards, and sometimes appearing at, the
pit of the stomach : general languor; pale or
yellow countenance; dyspepsy: dejections
irregular, often whitish.

Physconia hepatica. Cuss. Sauv. Cull. Parr.

, In strict propriety, physconia should perhaps be confined not only
to the region of the abdomen, but to those knotty or unequal intu-
mesceuces which evidently proceed from an indurated, usually a pa-
renchymatous, enlargement of one or more of the viscera contribut-
ing to the digestive function, and which in a greater or less degree
derange its perfection, or impair the general health bf the system;
while all other swellings which have hitherto, in different nosolo-
gies, been made to range under it, should be transferred to other
genera. Such is the limitation aimed at in the present arrangement,
and we hereby obtain a family of diseases analogous in origin, situ-
ation, general result, and mode of treatment : and which ought ra-
ther to be entered in the class before us than in Class VI. Order I.
Eccritica Mesotica, which comprises a list characterized by morbid
enlargement of the parenchyma without derangement of the general
health. With this limitation the author had at first intended to con-
tinue the term physconia; but apprehending it might lead to mis-
takes, from its different use by other writers, he has thought it bet-
ter, upon the whole, to reject it altogether, and employ another
term in its stead — a term not invented for the purpose, but in use
among the Greek writers, and in itself sufliciently indicative of its
intention.

1. 3 E. hepaticum^ Hehninthicum. — Similar animalcules, and espe-
cially hydatids, are occasionally found in other organs, though less
frequenly : particularly the kidnies and the testicles: but ns they
can rarely be traced by any external symptoms, they can seldom
become a subject of symptomatic nosology. See Baillie^ Morb.
Anat. Fasc. vi. pi. 7, and Fasc. viii. pi. 8. The existence of flukes
{fasciola hepatica) in the human liver is doubtful, though asserted
by Doever, Darwin, and others. Dr. Harrison, of Horncastle, Lin-
colnshire, in his treatise on the Rot in sheep, denies their existence
in this disease, even among these animals; and has given proofs of
their total absence in many of the worst cases upon dissection. He
ascribes the rot to marsh miasms. The present writer, however, has
se(!n them in prodigious numbers; and their non-existence, at parti-
cular times, or in particular cases, only seems to show, that, if at
any [lenod a cause of this disease, rather than an effect, they are
not the only cause.

GE. iV.j N6S0L0GY. 65

Hepatis tumor. Darw. i. ii. 3. 9.

Jekur akend. Pers. Literally jecMrcoac/wm. The Latin

termjecwr is probably derived from the Persian.
tt Coactura. From infarction.

Found in feeble children, who secrete less bile, and
have the cells of the liver clogged with mucus from ato-
ny of the absorbents. — Found also in intemperate livers;
and in foreigners who reside in hot climates : an unequal
atony, and at times paralysis, being produced in the or-
gan from the excessive stimulus antecedently excited by
the rays of the sun or the use of spirituous potation.

The diseased viscus often acquires great weight :
18 lbs. Bonet. Sepulcr. lib. i. sect, xviii. — 20 lbs.
Bald, N. Magaz. band vii. p. 275.-28 lbs, in an hy-
dropic. Gooch, Med. and Surg. Obs.
C Scirrhosum. The tumour assuming a scirrhous charac-
ter. Geors. Seseri Alis. Nat. Cur. ann. iv. obs. 142.
Chololithicum. Accompanied with bilious concretions.
Bond. Sepulcr. de Hypocondr. tumor. Obs. 8. ' Ver-
d'uc. Pathol, du Rachitis.
§ Helminthicum. Accompanied with flukes, hydatids, or
other worms. Winker. Disp. de Hydat. apud Bonet.
Med. Septentr. ii. p. 313. — Darw. vol. iii. 156. 8vo.
2. sPLENicuM. Indurated tumour below the false ribs on the
left side, and towards the spine on the same
side; pale countenance; general debility.
Physconia splenica. Saiiv. Cull. Parr.
Splenis tumor. Darw. i. ii. 3. 18.
Ague-cake.

tt, Coactum. From infarction. Chiefly after obstinate re-
mittents or interraittents in organs weakened by pre-
vious intemperance ; the absorbents being hence dou-
bly debilitated.
Emphratica: Holler. Disp. Pathol, iv. 109.

Sometimes continues lor thirty years. Darzo. ut su-
pra.— Sauv. in loco. — Tulp. Obs. Med. ii. 30 — Morgagn.
Ep. XX. 52. et passim — Baillie, Morb. Anat. Fasc. vi. pi. 2.
' Scirrhosum. Assuming a scirrhous character. Bonet.
Sepulcr. de Ventris tumore. Obs. xxxiv. n. 3. On
the death of a woman, found to weigh thirty-three
pounds, and to fill nearly the whole of the abdomen.
Complaint lasted seventeen years before the patient
died, during nearly the whole of which she pursued
her usual avocations. Sauv. in loco. — Three times its
9

66 NOSOLOGY. [^CL. I.-OR. II.

natural size. Baillie, Morb. Anat. Fasc. vi. pi. 3. —
Contained fifteen pints of pus. Histoire de PAcademie
des Sciences, 1753. p. 196. The entire viscus has often
been extirpated without injury.
y Cartilaginosum. The coats of the spleen converted into
a cartilaginous substance. Baillie, Morb. Anat. Fasc.
vi. pi. 1.

3. PANCREATicuM. Hard elongated tumour, running transverse-

ly in the epigastric region; dyspepsy;
general languor.

Torpor pancreatis. Darw. i. ii. 2. 7.

Ecphyraa physconia. Young.

et Coactum. From infarction. Baillie, Morb. Anat. pi.
vii. fig. 1 — Torpitude produced by the stimulus of to-
bacco, almost incessantly chewed or smoked for many
years ; fatal. Darw. uf supr.

C Calculosum. Accompanied with white calculous con-
cretions. Baillie ut supr. fig. 2, 3, 4.

4. MESENTERicuM. Indurated and irregular mass of tumours

below the stomach, yielding to the pres-
sure of the hand : pale, bloated counte-
nance; atrophy ; the appetite at the same
time seldom diminished, often voracious.
Physconia mesenterica. Cuss. Sauv. Cull.
a Helminthicuni. Accompanied with hydatids or other
worms. Greg. Horsf. lib. v. obs. 33. — Tulp. obs. lib.
ii. c. 34.
^ Strum6?um. Accompanied with scrophula. Bonet. ex
Rudnicio de Ventr. tum. obs. 10. — Ambrose Pare, 1.
c. 21— f/«m. Rad. Med.
y Scirrhosum. Accompanied with scirrhus. Marc. Do-
nat. Hist. Med. Mir. 1. vii. c. \b — Trincave.U, iii. cons.
22 — Riolan. Anthropogr.'l. ii. c. 26 — Mor^agni de Sed.
Ep. 39. n. 2.
3 Sarcomaticum. Accompanied with sarcomatous excres-
cences. Bonet. Sepulcr. de fals. gravid. Obs. 3. n. 1.
E Steatomatosum. Accompanied with steatomatous excres-
cences. Barlhol. Cabrol. Obs. 33. 35. Tulp. obs. ii.
32. 33. Joh. Lechelii apud Bond. Med. Sept. ii. 486.
Hierne Collect. Acad. iii. 226.

Tumour weighed 40 lb. Nov. Act. Nat. Cur, Vol.
i. obs. 92.
I Fungosum. Accompanied with fungous excrescences.
Bonet. Sepulcr. dc gravit. fals. obs. 3. c.

GE. IV.]

NOSOLOGY.

(i7

Sarcoma mesenterii. Pigr,
Suasarcosis. Auct. Var.
Champignon. F.

The above varieties and many of the references are
from Sauvages, who has been copied in both by Cullen.
The tumours are often very large, and conglobated : and
at times accompanied with cysts filled with a limpid fluid.
In one instance these amounted to twenty of various
sizes, one as large as a child's head, six as large as the
fist, and the rest resembling hens' and pigeons' eggs.
Hence the whole abdomen is in some cases so generally
tumefied as to give a semblance of pregnancy. This is
particularly the case with the last variety ; and as the
appetite, state of the bowels and bladder, are often un-
affected, there is not unfrequently some difficulty in de-
termining the nature of the disease. See Sanvag. in
loco; as also the writings of Welsch, Trincavelli, Mor-
gagni, and Riolani, who have made collections of extra-
ordinary cases ; and conjpare Cruikshank on the "Ana-
tomy of the absorbing Vessels," p. 115. 2d edit. 4tQ.
^. iNTESTiNALE. Tumour hard and circumscribed, round or
elongated; moveable upon the pressure of
both hands; irregular dejections; obsti-
nate vomiting; pyrexy; and for the most
part emaciation.
Physconia intestinalis.- Cusson. Sauv. Gull.
« Conglomeratum. Cohesive, and conglomerated. Mor-
gagn.' de sed, et caus. Morb. torn. ii. ep. 39. In
this case the tumour lay sensible to sight, of a circular
shape between the ensiform appendix and navel. On
dissection, the ileum and adjoining portion of the je-
junum were retracted upwards, coacervated, and firm-
ly adhesive.
C Sarcomatosum, Sarcomatous. Fantoni. Obs. Med. se^
lect. ii. In this case the tumour, of an oblong shape,
lay below the left hypocondrium inclining to the epi-
gastrium, prominent, with unequal hardness. On
dissection, every other part being found healthy, the
colon, under the stomach, and towards the left side,
for the length of the palm of the hand, appeared
closely indurated, distended, and loaded with a fleshy,
fibrous, peculiarly thickened tumour, which contract-
ed its diameter.
6. OMENTALE. Tumour indurated and diftuscd ; frequently

68 NOSOLOGY. [CL. I.-OR. M.

spreading over the whole of the abdominal
region ; dyspncea ; emaciation.
Physconia omentalis. Cuss. Sauv. Cull.

This species is usually of a mixt kind : infarcted ;
scirrhous; glandular; and cartilaginous, h has been
found of various extent and magnitude ; from a weight
of five pounds to twenty, twenty-five, thirty, and in
one instance {Greg. Horstii. Prob. 10. dec. vi.) fifty-six
pounds, occupying the whole capacity of the belly. In
one case, the hardness was almost stony : Panarol.
Pentec. iii. obs. 10. In another, osseous, the weight
thirteen pounds : Mongin., Hist, de I'Acad. des Sciences,
1732. In a third, loaded with many thousand glan-
dules : Seger, Ephem. Germ. In a fourth, accompa-
nied with excruciating pains, the weight sixteen pounds :
Huxh. Phil. Tr. Vol. vii.
7. coMPLiCATUM. The belly hard, elevated, and distended as
though pregnani, and often supposed to
be so ; yet more or less knotty and une-

7. Parabysma complicaium. The symptoms of this species must
vary according to the organs affected, and the nature ;ind extent of
the disease. The enlargement is generally found to be sarcoma-
tous, scirrhous, hydatidous, or adipose. The liver is in most cases
more or less concerned — sometimes in connexion with the spleen,
sometimes with the mesenter}', sometimes with the stomach or in-
testines, and sometimes with all together. Hildanus found the liver
so enlarged as to pass beyond the false ribs of the left side, with
the spleen equally enlarged, and lixed to the hepatic lobe. Cent,
ii. Obs 45. Huidenreich, in a woman of forty-five years of age,
found the liver scirrhous, weighing fourteen pounds, with a fleshy
excrescence in the mesentery of the size of a child's head : Miscel.
JVat. Cur. ann. vi. and vii. Jaundice accompanied this case. — Bar-
tholine mentions a woman of elegant form in the flower of her age,
attacked with another variety of this disease, which at length de-
stroyed her: when all the intestines, liver, spleen, and every ad-
joining viscus, were found intermixed, and buried in fat ; the
liver being at the same time enlarged and scirrhous, and fill-
ing both hypocondria ; the stomach thickened, and cartilaginous :
Cent. ii. Obs. G. — Coiter found the whole of these organs ad-
hering together, and filled with cysts of difTi'rent sizes distended
with a limpid fluid : he reckoned moiT, than fourscore : (he organs
themselves were exhausted and dry. Obs Anat. p. 117.

There are instances, however, in Schenck, Vrsalius, Helvetius,
and others, vvliere this disease has been eu<Iiired (or 3'ears without
much inconvenience: chiefly, however, in cases where the enlarge-

GE. IV.] NOSOLOGY. 69

qual : the breathing seldom impeded : for
the most part, acute pain, nausea, obsti-
nate vomiting, and thirst.

Physconia polysplanchna. Cuss. Sauv. Cull.

Physconia visceralis. Auc. Var.

tnent has been confined to a single visciis, forming the megalos-
planchnus {fiiy»M<r7rXxyx,'»oi) of Hippocrates.

CLASS II.
PNEUMATICA.

DISEASES OF THE RESPIRATORY FUNCTION.

ORDER I.

PHONICA.

AFFECTING THE VOCAL AVENUES.

The passage of the voice impeded ; or its power suppressed
or depraved.

GENUS I.

CORYZA.

Defluxion from the nostrils, obstructing their channel.

Class II. Pneumatica. UnvfAXTtKec, " ad spiritum vel respiratio-
nem pertinentia," from ?rv6<y, " spiro :" and hence crvst;^, pulmo,
" the breathing organ."

Order I. Fhonica. (Paivixx, " ad vocem pertinentia,'' from <pw»«,
" vox ;" and hence aphonia «<?<»««) Gen. IV. under the present or-
der, from a, privation, and (pai*y) ; and dysphonia {}ucr<pcivix.) Gen. V.
from 3t;j, " male," " perr)er'4m," and ipmn-

Gen. I. CoRYZA. Ko^y^a, Hippocr. '^gravedo," " distillatio :"
" cold, infarction, or stiiHing in the head," " defluxion." Galen
confines the term to defluxion on the nostrils alone. De Symp. Cans.
lib. iii. c. 4. The idea of the Greek physiologists was that of a
condensation of the secreted fluids of the head by cold, so as to
distil or trickle down the passages that lead from it, as we see the

GE. l.j NOSOLOGY. 71

Coryza. AucL Grcec, Sauv. Linn. Vog. Sag.
Distillatio. .^uct. Lat,
Stillicidium narium. Bidloo,
Phlegmatorrhagia. Junker.
Nuzlet. Arab.
Pfnufel. G.
Running at the. nose.
\, ENTONicA. The defluxion pellucid, mucous, or ropy, with a
sense of irritation or infarction.

vapours of the atmosphere, when condensed by the same means,
trickle down glabrous conductors of any kind. The term is admira-
bly calculated to express the whole of this idea, though its deriva-
tion has been sought for in vain by the etymologists ; in conse-
quence of which it stands in Scapula, and all the best lexicons, as
a Greek radix. The anther begs to suggest, that it is of Asiatic
origin, and occurs in almost all the cognate dialects of the east in
the same signification, and almost without the change of a letter,
uniformly importing cold, and the effects of cold. Thus in Syriac
it is written korusa, and is expressly used in the Syriac New Tes-
tament in the sense of aIgor,frigus ; see John xviii. 18. Acts xxviii.
2. In like manner in Chaldee it is written Ktt^Tlp {konjsa^ or more
strictly korusa^ as in the Greek,) and imports precisely the same.
See Jonath. on Gen. xxxi. 40. In this tongue also it occurs as a

verb in Job x. 10, and xxxviii. 30, tt^^p {koris or korys,) and signi-
fies " frost, constriction, condensation," (^gravedo^) as the effect of
cold ; synonymously with the Hebrew terms "127 and ^<^p. The
Hebrew, however, possesses also the very same word, though in

a remoter sense ; for ti/lp in Hebrew implies " close-grained, com-
pact wood or timber," in which signification it is used in Ezek.
xxvii. 6, and in various other places. It is highly probable that we
should find the radical idea of the term in Hebrew, as well as in
Syriac and Chaldee, if we had other classical Hebrew books than
the Old Testament to have recourse to ; for the Arabic contains
the Hebrew term, and gives us to the present day (^ko7-is or korys) in
the sense of cold as well as of impaction as its effect, and this too
both as a noun and a verb : whence {leiletum zatu korysin) is nox al-
sida.

Hippocrates, as we learn from Celsus, applied coryza equally to
defluxions from the head, nostrils, fauces, and chest. The later
Greek physicians restrained it to the first, and distinguished the two
latter by the name of cataslagmu§ (jtotToio-rayjKej,) which equally im-
ports distillatio or defluxion. Among modern writers coryza is used
synonymousi}' with catarrh, and is consequently regarded as a fe-
brile afiection. It mav indeed occur, and often does so, in variou.'^

72 NOSOLOGY. [CL. II.-OR. I,

et Sternutatoria. From sternutatories.
C Lachryniosa. From weeping or crying; the lachry-
mal secretion being increased by mental emotion.
Snivelling.
V Catarrhalis. From sudden cold or change in the tem-
perature of the atmosphere ; accompanied with a
nasal voice and loss of smell ; and excoriation of the
mucous membrane of the nostrils. Gravedo. Aucf.
Var.
Coryza humida. Nenter.
Schnupfen. Schnuppen. G.
Enchifrenement. F.

Cold in the head. In Old Engl. Pose or Mur, whence
Murren and Murrain.
3 Ozoenosa. The defluxion more or less purulent, or
ichorous and fetid.

fevers as a symptom, but the older nosologists are more correct in
giving it a place distinct from fever, when strictly genuine. De-
fluxion from the nostrils may proceed from two very different sets
of causes : increased action of the secernents, and diminished ac-
tion of the absorbents. The first or stimulating set may consist of
sternutatories ; of the irritation of sympathy, as in crying ; of in-
fectious effluvia in the atmosphere (sometimes, though seldom, limit-
ing their action to the mucous membrane of the nostrils, and hence
approaching the nature of catarrh ;) and of the local stimulus of an-
ozena or nasal ulcer.

The action of the absorbents may be diminished by exposure to
severe cold ; by the debility of old age ; and by a long habit of
sternutatories, which have a tendency, in proportion to their use,
to render all the vessels of the nostrils torpid; although the absor-
bents, as in the cases ef age and cold, and indeed in all instances of
debility, are sooner operated upon than the secernents. Here,
therefore, the defluxion is produced, not from increased secretion^
for the secretion may even be less than in a state of health ; but
from the secretion, whatever its quantity, not being carried off b\'
its usual channel: and hence again that frequent and unsightly drip-
ping from the nostrils of persons who addict themselves to large
quantities of snuff. The author has seen the same effect produced
by an habitual use of ha'-tshorn and powerful aromatics.

1. S. C enlonica^ Ozienosa. Sauvages makes this variety syno-
nymous with the disease called distemper^ or snujfles, as it is provin-
cialiy called, of dogs and horses, the morvc of the French veterina-
ry writers. But the distemper is evidently a contagious catarrh, with
a considerable degree of pyrexy, and usually phlogosis of the bron-

GE. I.] NOSOLOGY. 73

Coryza virulenta. Sauv.
Ozoena. Bonnet. Sepulcr. i. 406.
2. ATONicA. The defluxion limpid, and without acrimony, or
sense of irritation,
as Algida. From exposure to a keen, frosty, air.
£ SeniHs. From old age.

y Superacta. From long and immoderate use of strong
aromatics, volatile alkali, or snuff.

GENUS IT.
POLYPUS.

A lieshy, elongated excrescence, shooting from one or more
slender roots in the cavity of the nostrils, running in
different directions, and affecting the speech.

Polypus. Cels. Heister, Vog. B. Bell.

Sarcoma narium. Sauv. Cull.

Polype. F.

Polypus.

chia. It belongs, therefore, to Class III. Order II. of the present
arrangement.

Gen. II Polypus. Uoa-vtcov? ; so called from its general resem-
blance to the well known worm of this name, the hydra viridis of
Linneus. It has lately been the custom to apply the term polypus
to a variety of concretions and excrescences arising in different
parts of the bodj', of very different origins and textures, as polypi
of the heart, which are perhaps always grumous blood, or concrete
gluten; polypi of the uterus and bladder, whichjire caruncles with
a slender base or peduncle; and polypi of the trachea, which are
also concrete gluten, occasionally coughed up, sometimes solid and
branching, sometimes tubular. In the present instance the author
has followed Celsus, and most writers from his time to that of Heis-
ter, in restoring and limiting it to the fleshy and ramifying excres-
cence of the nostrils; and will denominate those that in other or-
gans make an approach to its form or consistency, and which are
seldom capabj^e of being determined by symptoms, ■polypous tumours,
caruncles, or excrescences, rather than genuine polypi. Vogel's
d. finition is equally restrained, though sarcoma is not quite a correct
term; "sarcoma intra narcs praelongum, pluribus appendicibus ad-
hserens:" Mr. B. Bell uses the term in the same limited signitica-
10

74 NOSOLOGY. [CL. II.-OR. !•

1. PLASTicus. Soft, compressible, chiefly pale-red ; apparent

]y originating from distension, or relaxation
of the Schneiderian membrane.
Soft, campressible Polypus. B. Bell.

2. coRiACEUS. Firm, cartilaginous, chiefly deep-red ; apparent-

ly originating from, or connected with a caries
of the ethmoid bone.
Firrrt, cartilaginous Polypus. B, Bell.

GENUS III.

RHONCUS.

Hoarse, sonorous breathing from stagnation of mucus in

the vocal canal.
Rhencus, (pey*ej.) Hippocn
Stertor. Sauv.
Khatyt. Arab.
1. STERTOR. The sound deep and loud ; produced in the la-
rynx and fauces.

lion. Surg. vol. iv. ch. xxviii. sect. 5. See also Hewson's Inquiries,
part. i. p. 25.

The grumous coagula of the heart, according to the peculiarity
and extent of pressure they receive, are sometimes moulded into an
uncouth and serpentine form, and have occasionally been mistaken
for real serpents ; and hence a wonderful book was published in this
metropolis in 1639 by a practitioner of the name of Edward Maya-
met, entitled a " True Relation of a Strange Monster or Serpent
found in the left Ventricle of the Heart of Pennant."

Gen. III. Rhoncus. 'P«y;^«5, from 'fsypijw, " ronchisso, sterto." Ga-
len supposes this word to be an onomatopeia, or mere imitation of
the sound produced during the action of snoring or wheezing. Cul-
len has omitted the genus as conceiving it to be nothing more than
a svmptom of some other afi'ection. Vogel, and a few other nosolo-
gists, on tlio contrary, have raised both the species here offered to
distmct genera. To this they are hardly entitled ; but it requires
only a ruivrow Unowledgp of the habits and morbid actions of the
animal system to discover instances in which both sorts are idiopa-
ihic. Many persons have a thick or wheezy respiration, produced
b_5 < Tpulency, or by changes of the atmosphere from hot to cold»
or iVon, «lry to moist, without any other diseased affection. Many
persons Htior6 habitually during sleep, and most persons have a t«n-

GE. III.] NOSOLOGY. 7^

Renchus. Vog.
Schnarchen. G.
Sterteur. Fr,
Snoring.
2; Cerchnus. The sound dense, and impeded ; produced be-
low the larynx.
Rhochmos. Vog.

Heischerkeit. G. ■ ■ '

Ralement. Fr.
Wheezing. Rattling in the throat.

GENUS IV.
APHONIA.

Inability of speech.
Mutitas. Sauv. Cull. Vog.
Aphonia. Linn. Cricht. Plouquet.
Bekym. Arab.
Stummheit. G.
Dumbness. Speechlessness.

dency to do so, as they grow old. Such affections are strictl}' idio-
pathic; they are not often indeed accompanied with much inconve-
nience ; but, as deviations from a perfect state of health, have a full
claim to their respective places in a general system of nosology. In
botony the most insignificant plant is allotted its proper station.
Cerchnus (Ktpj^yes) is derived from ki^^u^ " rauceo," or rather " ir-
raucesco."

Genus. IV. Aphonia. A(p«v/<e : See note on Phonica. There is
some disagreement among the nosologists in arranging the diseases
that affect the power of speech. Linneus places the whole under
two genera. Aphonia and Psellismus ; Sauvages and CuUen under
four, Mutitas, Aphonia, Psellismus, and Paraphonia ; while Vogel
gives not less than twelve, Asaphia, Clangor, Raucitas, Aphonia,
Leptophonia, Oxyphonia, Rhenophonia, Mutitas, Traulotis, (Blagsi-
tas) Psellotis, (Balbuties; Ischnophonia, and Battarismus. It will
easily be conjectured from this list that Vogel has matle distinct ge-
nera of many afieclions which ought to be nothing more than species
or varieties ; and that Linneus has sunk into species some all'ections
that ought to rise into the rank of distinct genera. Lpon the v. liole,
therefore, the arrangement of Sauvages is the best; and Dr. Cullen
has shown his usual judgment in following it. The present mdnod

76 NOSOLOGY. [CL. II.-OR. I.

1 . ELiNGUiUM. Speechlessness from destitution of tongue.

Mutitas organ ica. CtiU.

Mutitas elinguium. Sauv. — Privation of the tongue is not
ahvays accompanied with dumbness : since we have
numerous, and apparently well-authenticated instan-
ces of the speech remaining perfect after a total loss
^of tongue and of uvula. See Phil. Trans. 1742, p.
143 ; id. 1 747, p. 621 ; Ephem. Germanic, vol. iii. Eph.
Nat. Cur. passim.
Byzeban. Pers.

ei Congenita. The destitution coeval with the birth.
S Oblfesa. The destitution produced by accident, punish-
ment, or disease.
Reunited, after being nearly cut otf. Van Wy, Heel-
kondige Mengelstossen ii. Dec. 1. Frank pretends a
case of regeneration. Salyr. Med. p. 120.

2. ATONiCA, Speechlessness from atony of the vocal organs.

«5 Oblaesa. From lesion of the nerves of the tongue.
Mutitas atonica. Cull.
Mutitas traumatica. Sauv.

Enduring for ten years with paralysis, and then sudden-
ly ceasing. Bresl. Sammlung, 1721, ii. 406 — 503.
b Pathematica. From sudden and overwhelming terror,
or other violent passion. Commonly temporary :
sometimes permanent.

3. surd6rum. Speechlessness from deafness, congenital or pro-

duced during infancy.
Mutitas surdorum. Sauv. Cull.

goes between Linnfeiis and Sauvages, and offers three genera, apho-
nia, the mutitas of Sauvages, and Cullen : dj'sphonia, including the
aphonia and paraphonia of these writers; and psellismus. Mutitas
and aphonia are direct synonyms, and equally import dumbness or
speechlessness. The Greek term is merely preferred to the Latin
in the present system in conformity with the general rule ; but it is
not a little singular that in Sauvages and Cullen both these terras
should be made use of, in different senses, and as names to different
genera. Linneus and Crichton have restored the Greek term to its
proper signification.

2. «. J. atonica OhlcRsa. Galen and Sauvages advert to cases of
dumbness produced by i^xcision or erosion of the recurrent nerves
both in man and quadrupeds ; as also to others in which they were
injured by extirpation of the glands of the neck in struma, cancer, oi-
bronchocele.

GE. v.] NOSOLOGY. 77

Mutite des sourds de naissance. Fr.
Deaf-dumbness.

GENUS y.

DYSPHONIA.

The sound of the voire imperfect or depraved.

1, susuRRANS. Voice weak, whispering, and scarcely audible.

Aphonia. Sauv. Cull.

ee. Oblaesa. From lesion of the nerves of the larynx.
Aphonia traumatica. Saux.
Aphonia atonica. Cull.
€ Patheraatica. From sudden and overwhelming terror,
or other violent emotion of the mind : occasionally
permanent.
y Compressoria. From permanent compression of the
trachea.
Aphonia trachealis. Cull.
Aphonia aneurismatica. — A. pulmonica. Sauv.
§ Catarrhalis. From neglected catarrh.

Aphonia catarrhalis. Sauv.
E Enervis. From simple debility of the larynx without
any obvious cause.

The author has at this time a case under his care
produced in this manner, in which the patient, about
forty years old, and otherwise in good health, has
never spoken, except in a whisper, for the last six
years.
Paraphonia rauca. Cull.
Raucedo. Lxn.
Raucitas. Vog.

2. PUBERUM. The voice dissonant and untrue to itself, irregu-

larly alternating from harsh to shrill ; confined
to the age of puberty.

Gen. V. Dysphonia. kw^misc. See note on Phonica, asalso the
preceding note.

\. y D. susurrans, Compressoria. Sauvages refers to Morgagni
and Bonetus for cases of severe compression from aneurism of the
aorta, enlargement of the thymus, and various other tumours.

78 NOSOLOGY. [CL. II.-OR. I.

Paraphonia puberum. Sauv. Cull.
Mue de la voix. Fr.
Change of Voice,
3. iMMODULATA. The voice permanently depraved, or inhar-
monious.
« Rauca. Naturally or habitually hoarse, harsh, or rough.
S Nasalis. Sent with a cracked and grating sound through
the nostrils,
Paraphonia nasalis. Sauv.
Paraphonia resonans. Cull.
Rhinophonia, Vog.
Nasitas. Auct, Lat,
Khemkhemet, Arab. Pers. Turk.
Parler du nez. F.
Speaking through the nose.

Produced by habit, affectation, or nasal obstruction,
y Clangens. Shrill and squalling.
Paraphonia clangens. Cull.
Paraphonia ulcerosa. Sauv.
Oxyphonia, — Leptophonia. Vog.
5 Sibilans. Wi^h a whizzing or hissing sound.
Syrigma. Atict. Grcec,
Paraphonia Sibilans. Sauv.
Zischen, G.
Sifflemcnt, F.

Found also sometimes as a symptom or sequel of va-
rious nervous diseases, colic, or bilious vomiting,
5 Stertens, With a snorting, snoring, guttural, or sterto-
rous sound.
Paraphonia stertens. Sauv,
Paraphonia comatosa. Cull,

Usually from relaxation of the glottis or velum palati.
^ Palatina. Hoarse, obscure, indistinct; with a fissure
or other defect in the palate.
Paraphonia gutluralis. Sauv,

3. i. D. immoduata^ Enirvis. A lady, of about forty-five, of easy
temper, has heen snhjpct to this variety for several years. It attacks
in jiaroxysms recurring at irregular periods, and usually continuing
for five or six works, nnloss sooner relieved liy stimulants an«l tonics.
1 he voice is a low whispor duiinef the whole of the paroxysm.

Found also occasionally as a symptom in melancholic paralytic,
and hysteric affections; and var. y m pansthmitis, dysphagia, and
catarrh.

GE. VI.] NOSOLOGY. 79

Paraphonia palatina. Cull.
Asaphia. Vog.

The defect mostly congenital : occasionally a sequel
of lues and some other disorders.

GENUS VI.

PSELLISMUS.

The articulation imperfect or depraved.
Psellismus. Sauv, Linn. Sag, Cull,
1. Bambalia. The flow of the articulation disturbed by irre-
gular intermissions or snatches.
Timtamet. Arab. An onomatopy produced by an itera-
tion of the letters t and m, which are most difficult
for the stammerer to articulate.
Stammlen. G.
Begayement. F.
Stammering.

« Haesitans. Involuntary and tremulous retardation in
articulating particular syllables.
Psellismus ischnophonia. Sauv,
Ischnophonia. Vog,
Anstossen. G.
Hesitation. F,
Hesitation.
C Titubans. Involuntary and tremulous reduplication of
some syllables, alternating with a tremulous hurry of
those that follow.
Psellismus. Linn.
Battarismus. Vog.
Stottern. G,
Bredouillement. F.
Stuttering,

Gen. VI. Psellismus, 4^?iXt<rft»i^ from 4'«^A'^«;, " balbutio." The
Greek term however was used in a wider sense than the LatiD,
so as to import every species of depraved or vitious articulation ;
and in this sense it is employed in the present system. The
Romans gave the name of ba/nbaliones from ZocfcQxXt^M, " raptim ar-
tieulo," " to articulate by snatches," — to those who, properly speak-

80 NOSOLOGY. [CL. II.-OR. I.

These two varieties of stammering are thus well de-
scribed by Shakespear : " I would thou couldst slam-
mer, that thou mightest pour out of thy mouth, as wine
comes out of a narrow-mouthed bottle, either too much
at once or none at all."
3. Bl^sitas. The enunciation vitious.
Blaesitas. And. Lat.
Traulotes (r^ecvMrn?.) Auct, Grcec,
Aiken. Arab.
X Ringens. With a vibration or redoubling of the letter Re

Psellismus ringens. Cull.
C Lallans. The letter L unduly liquid, or substituted for
R. As when delusive is pronounced deh'usive, as
though the / possessed the power of the Spanish U,
or the Italian gl ; or as when parable is pronounced
pa/able. Alcibiades is supposed to have laboured
under this defect. It is also said to be common to
the Jews of China, who have dwelt among the Chi-
nese so long as to have lost the sound of R, in conse-
quence of its not existing in the Chinese tongue;
and who consequently pronounce in Gen. i. 1.
Kbl n^ly^*bl for i^-)i h^li^Kni.
Lallatio. Auct. Lat.
Psellismus lallans. Cull.
Psellismus lambdacismus. Sauv.

y Emolliens. The harsh letters exchanged for soft, as in
the substitution of anzel for angel ; capic^ol for capi-
i6\ ; rfat for </iat.
Psellismus traulotes. Sauv.
3 Balbiitiens. Labials, as M. B. P, too frequently intro-
duced, or used instead of other letters. So Feda is
pronounced ^eda, Fenares, J5enares in Bengal, the
Bengalee having no V. So impringe is often used for
in/ringe ; ifcory for i^jory ; though h and not v is here
the radical letter, the Latin term being efcur.
Psellismus balbutiens. Cull.

Ing, stammererl, whether by involuntary hesitation or hurry of ut
teranee : and hence the author has employed bambalia for the first
species of psolli«miis.

2. 6 P. BloRsitas^i Mogilalia. ^The term, as given in the text
from Sauvages, is that used by Aetius, who denominates the subjects
of this vitious enunciation mogilali. Dr. Cullcn does not seem to
have gained any thin^ by substituting acheihs.

€1E. VI.] NOSOLOGY. 8 I

« Mogilalia. Labials omitted or exchanged for other let-
ters.

Most commonly P. for F and F for V, as/iifer for
pilfer; rish for/ish, antle for mantle. So the Latin
sifeilo is transformed by the French into siller.

Psellismus mogilalia. Sauv.

Psellismus acheilos. Cull.

Faifait. Arab. An onomatopy or imitation of the sound
produced by a vitious reduplication of the letter/.
^ Dentiloquens. Dentals, as C, S, T, Z, too frequently
employed ; producing the effect of what is called, in
common language, speaking through the teeth.

Asthenia vocis, Thetismus. Young.

Lispeln. G.

Grasseyement. F.

Lisping.
«! Gutturahs. Imperfect utterance of the guttural letters ;
as G. J. H. X.

Psellismus jotacismus. Sauv.

Psellismus lagostomatum. Cull.

ORDER IL

PNEUMONICA.

AFFECTING THE LUNGS, THEIR MEMBRANES, OR MOTIVE POWER.

Respiration irregular, impeded, or painful.

2. ^. P. Blccsitds, Dentiloquens. Holder, in his " Elements of
Speech,"" has accounted for this depravation as follows : " Appulse
partial, giving some passage to breath, is made to the upper teeth,
and causes a lisping sound, the breath being strained ti rough the
teeth."

2. ». P. Blossitas, Gutturalis. This, and indeed all the varieties
of the present species, as well as many others that are connected
with it, are most usually the result of vUious habit, pruducfd by
want of attention to the articulation of sounds in infancy, or to af-
fectation. They are also sometimes dependent upon a miscon-
struction of the vocal organs : of which the present variety fur-
nishes us with an example ; for a defective utterance of the gut-

n

82 IVOSOLOGY. [CL. I7.-0R. II.

GENUS L

BEX.

Sonorous and violent expulsion of air from the lungs.
Bex (ful-) ^'Jnct. Grose.
Tussis. Ceh. Sauv. Linn, Vog. Sag.
Catarrhus. Cull.
Pneusis Tussis. Young.
1. HUMiDA. With expectoration of a mucous or serous fluid-
Anaptysis (etvctTTWii.) Hopporr.
Ahacatharsis. Gal. Sauv.
Expectoratio. Linn.
Soal. .i^rab.
Husten. G.
Toux. F.
Common cough,
cc Mucosa. The discharge chiefly mucous and excretecf

freely.
C Anhelans. The cough in long paroxysms ; the discharge

tural letters must be a necessary consequence of a fissure in the
palate.

Order II. Pneumonica. T\nvftmx.»\ "ad pulmonem pertinentia ;'*
From nw«, " spiro."

Gen. I. Pex. b-^: " tussis :" C^t7«. " tussio." The Greek name
here restored for the sake of uniformity. Dr. CuUen's system does
not allow a place for cough as a distinct disease ; and he has hence
been obliged to enter bex, tussis, or common and dry cough, under
class i. pyrexia, order v. profluvia ; and pertussis or hooping cough
under class ii. neuroses, order iii. spasmi.

Mr. J. Hunter has observed, with his usual accuracy, that in-
coughing and vomiting, the lungs and stomach develop an equal vis
inertiae. " It is not necessary that the stomach should act violently
to produce an evacuation of its contents ; nor is it even necessary
that it should act at all: for the lungs themselves do not act in the
least when any extraneous matter is to be thrown up ; and coughing
is to the lungs what vomiting is to the stomach. The muscles of
respiration are the active parts in emptying the lungs, and can act
both naturally and pretcrnaturally. The action of vomiting is per-
formed entirely by the diaphragm and abdominal muscles ; and we
know that by the same action the contents of the rectum can be ex-
celled." Jlnim. Econ. p. 199. The late experiments of M. Majen-
•lic have fully confirmed these remarks.

GE. I.] ]:;OSOLOGY. 8^

mucous and viscid; excreted with difficulty, and la-
borious breathing.
Asthma catarrhale. — A. pneumodes. Saii'c.
Dyspnoea catarrhalis. Cull. Parr.
Chronic cough, of old age.

y Acrida. The discliarge thin, frothy, and saline : for
the most part excreted with difliculty. It is in most
instances an atonic affection of the lungs or of other
organs that associate in their action. Sometimes an
attendant upon the gouty, more frequently upon ine-
briates labouring under a diseased liver, to whom it
is peculiarly troublesome in the morning.

3 Periodica. Recurring at stated periods : partly restraina-
ble ; discharge thin, but not acrid.

Tussis periodica. Darw. IV. iii. 4. 3.

Tussis nervosa. Cricht.

Mostly common to persons of a nervous or hypocondri-

acal temperament.
-2. SICCA. Unaccompanied with expectoration.

Khabbet. Arab.

Schaaf-hustcn. G.

Secheresse de poitrine. F,

Dry cough.

«s Ingenerata. From irritation produced locally, as a scir-
rhous or calculous affection of the lungs. See BorelU^
cent. I. obs. 6, Zacut. lib. i. obs. 95.

5 Extranea, From irritating materials inhaled from with-
out, as minute particles of glass, lime-stone, and simi-
lar bodies ; and common to glass-cutters, hewers of
free-stone or sand-stone (arenarius Cos,) workers of
metals, and other mechanics.

5 Verminosa. From worms in the intestines, liver, or
other abdominal organs. Common to children with
large bellies, and pale emaciated countenances; and
still more so to sheep labouring under the disease
called rot, and whose livers are usually loaded with
the fasciola hepatica, or fluke. See also J/. Skragges
Morbi Artificum, AmcEnit. Academ. 1764.
3. CONVULSIVE. The cough convulsive and suffocative; accom-
panied with a shrill reiterated hoop ; and
frequently with vomiting: contagious.

Bex theriodes ((J»)| in^tc^hi.) And. Far.

Tussis convulsiva. Sauv.

Pertussis. .%Jen/?. Huxh, CuU.

84 NOSOLOGY. [CL. Il.-OR. II.

Soal-saol. Arab. Being the common Arabic term for cough
reduplicated to express vehemence.

Coqueluche. F.

Starcker-husten. G.

Hooping-cough. — Chin-cough ; or more cori'ectly Kin-cough
or Kind-cough ; literally Child? s-cough., from the Ger-
man kind, " a child.""

G E N U S II.

DYSPNCEA.*

Permanent difficulty of breathing, with a sense of weight
on the chest.

Gen. II. DvsPNCEA. Auff5r»8««, from St/j, " male," and wviat, "spiro."
Dyspnoea, orlhopnoea, and asthma, are treated of by Celsus as spe-
cies of the same genus, or rather as different degrees of the same
affection. " Omne," says he, "in difficultate spirandi consistit; sed
haec, ilum modica est, neque ex toto strangulat, Jw9-5r»e«K appellator;
cum vehementior est, ut spirare aeger sine sono et anhelatione non
possit, xa-Qftx : cum accessit id quoque, ne nisi recta cervice spiritus
trahatur, og^owvsta." Lib. IV. iv. 2. — Galen, however, treats of these
affections as distinct genera, and discusses them in remote positions.
The same diversity of view has occurred in modern times. Almost
all the continental writers make each affection a separate genus, as
does Macbride among the writers of our own country. CuUen makes
a genus of dyspnoea and of asthma, and merges orthopnoea in the
former. Dr. Farrand Dr. Young take as little notice of orthopnoea,
and, with CeUus, reduce dyspnoea and asthma to the rank of species,
under a genus which they denominate anhelatio or pneusis : a term
applied by Sauvages to an entire order. Crichton retains asthma
alone, appearing to regard both dyspnoea and orthopnoea as mere
symptoms of other affections. The present arrangement adheres
chiefly to that of Cullen. It raises dyspnoea and asthma to the rank
of distinct genera, pathognomically distinguishing the first by its be-
ing permanent, and the second by its being temporary and recur-
rent : and it contemplates orthopnoea, as a sort of asthma exhibiting
itself in a dyspnoic diathesis; as a dyspnoea with irregular exacerba-
tions. It coincides, therefore, with Cullen's view, who has loosely
regarded orthopnoea as a dyspnoea, — a disease never free from dif-

* In tlio " Sludi/ of Mfilicine,''^ the author introduces between the Genera Bix
and DysprMu, as the second Genus, that uf JL»arijngi/siniis. See Study of Medicine,
V«.i. I.'p. 3W.

(SE. II.] JVOSOLOGV. 85

Dyspnoea. Auct, Grac, Ccls, et neoteric,
Anhelation,

1. CHRONICA. The breathing uniformly short and heavy, most-

ly accompanied with a cough.
Dyspnoea. Boerh. Sauv. Linn. Vog. Sag.
Kurtzer-athem. G.
Behr. Arab.
Courte haleine. F.
Short breath.

X Extranea. From calculous or other earthy secretions
in the substance of the lungs thrown up by coughing.

Dyspnoea terrea. Cull.

Dyspnoea calculosa. Macbr.
t Phlegmatica. The habit phlegmatic or cachectic, with
scanty secretion of urine, and mostly oedematous ex-
tremities.

Dyspnoea pituitosa. Sauv.

Dyspnoea aquosa. Cull. Parr.
y Pinguedinosa. Accompanied with oppressive fatness.

Dyspnoea pinguedinosa. Cull.

Engbriistigkeit. G.

Pousse. F.

Pursiness,
3 Organica. From deformity or organic defect, or injury.

Dyspnoea traumatica. Sauv.

thoracica. Cull.

6 Vaporosa. From the mischievous action of metals or
other poisons.

Asthma metallicum. Sauv.

2. EXACERBANS. Subjcct to suddcu and irregular exacerbations :

the breathing deep, stertorous, acute, and
suffocative ; relieved by an erect position,
Catarrhus suffocativus. Bagliv. et alior.
Orthopnoea. Cels. Boerh. Sauv. Linn. Vog. Sag.
Suffocatio. Etmuller.
Pnigma. Vog.

Most of the varieties of the preceding species apply
equally to this.

Found, also, under the one or the other species, as a
symptom in aneurisms, polypous concretions, and other

ticulty of breathing; and still more so with that of Sagar, who cha-
racterizes it expressly as a permanent affection, subject to acute
paroxysms : " Morbus contimms^ acutus, subitanea, anhelatione sub-
limi, et fere suffocatoria, stipatus."

86 NOSOLOGY. [CL. II.-OR. II.

affections of the heart and larger vessels; in enlargements
and other affections of the abdominal viscera ; in empye-
ma, hydrothorax, worms, peripneumony, bastard peripneu-
mony, small-pox, and occasionally in severe attacks of
intermitting fevers.

GENUS III.

ASTHMA.

Difficulty of breathing, temporary, recurrent ; accompa-
nied with a wheezing sound, and sense of constriction
in the chest ; with cough and expectoration.
Asthma. Auct, Grac, Cels, et neoteric.
Tenk nefes. Arab.
Keichen. G.
Pousse. Asthme. F.
Broken-zvind.
Asthma.
1. siccuM. Paroxysm sudden, violent, and of short duration ;
constriction hard, dry, spasmodic ; cough slight;
expectoration scanty, and only appearing to-
wards the close of the fit.
Asthma siccum. Etmulkr Cricht.
Asthma convulsivum. Willisii Hoff'm.
Nervous asthma. Convulsive asthma.

ei Simplex. Without any manifest cause, or combination
with any other affection.

Gen. in. Asthma. Avtfist^ " anhelatio," " spirandi difficultas :"
probably from ««, " spiro." I' he species of asthma here ofiered are
taken rather from the practical writers than the nosologists, whose
species are, in effect, seldom more than varieties, and are here in-
troduced as such: being derived, not from the symptoms, which
alone constitute the specific disease, and sbould alone describe it,
but from the supposed cause. Even Floyer, to whom we are in-
debted for the most accurate delineation of the immoral asthma that
has hitlierto been given to the world, drawn from his ownsntferings
through a period of thirty years, has fallen into the same defect.
Macbride and Crichton are the only nosologists the author is acquaint-
ed uitii who have derived their species from the natural and pro-
per channels which have been alone attended to in attacking the dis-
ease, however writers may have been disposed to favour a more
speculative view in their arrangements.

GE. 111.] NOSOLOGY. i)/

Asthma spontaneum. Cull.
C Exanthematicum. From retropulsion of gome acrid hu-
mour from the surface of the body.
Asthma exantheinaticum. Snuv. Cull.
y Phlegmaticum. From repelled oedema of the extre-
mities in phlegmatic or cachectic habits, with scanty
secretion of urine.
Asthma cachecticum. Saw.
OEdema pulmonum. Aut. Var.

Possesses a considerable resemblance to dyspiioea
phlegmatica ; and both best relieved by a copious se-
cretion of urine.
5 Vaporosum. From inhaled fumes of metals, especially
of lead and arsenic, of sulphur, charcoal, nitric acid,
and other deleterious or poisonous substances.
Asthma metallicum. Sauv.
2. HUMiDUM. Paroxysm gradual, ingravescent, protracted ; the
constriction heavy, humid, laborious : cough
severe ; expectoration commencing early ; at
first scanty and viscid, afterwards copious
and free.
Asthma humidum. River. Cricht. Sauv.
Asthma humorale. Bailie.
Asthma flatulentum. Floyer.
Asthma pneumonicum. WilUsii.
Spitting or humid asthma. Floyer.
Asthme ordinaire. F.
Common asthma.

« Simplex. Without any manifest cause, or combination
with any other aifection.
Asthma spontaneum. Cidl. — This term in Cullen ap-
plies to the present variety, and to « of the preceding
species,
f Plethoricum. From plethora, or the suppression of some
accustomed sanguineous evacuation.
Asihma plethoricum. Sauv. Cull.
y Senile. Asthma of old age.
Asthma senile. Parr.

The one or other of the species found also, occasion-
ally, as a symptom in gout, hypocondriasis, syphilis,
and diseased viscera.

Gen. IV. Ephialtes. 'E(p<*fAT>jf, or s!r<aATj)?, " incubus," or " incu-
bo." The term occurs in MacroL»ins — Somn. Seip. lib. i, though not.

88 NeSOLOGY. [CL. II.-OR. II.

GENUS IV.

EPHIALTES.

Sighing, suffocative anhelation, with intercepted utterance,
and a sense of some external substance pressing heavily
on the chest : transitory.
1. ViGiLANTiuM. Produced during wakefulness; the pressure
severe, and extending over the abdomen;
respiration frequent, laborious, constrict-
ed ; eyes fixt ; sighing deep and violent;
intellect undisturbed.
Incubus vigilantium. Rhod. cent. i. obs. 54.
Ephialtes hypocondriaca. Sauv.

in Hippocrates, Galen, or Celsus. The author has restored this dis-
ease to the family of anhelations ; with which it was associated by
almost every writer before the time of Dr. CuUen. It here finds a
natural place, and answers to its prominent character. With sleep-
walking it has little or no connection, excepting that one of its spe-
cies occurs in the night and during sleep. Ephialtes vigilantium is
entered on the authority of Khodius and Sauvages : it is certainly
allied to epilepsy, liut seems more closely to square with the true
generic character of the present disease Sauvages gives us three
other species as he calls them, but wljich are only symptomatic of
other affections. Aurelianus affirms that Ephialtes occasionally proves
fatal from its suffocative violence ; and adds from Selimachus, that
it was at one time as contagious and destructive at Rome as the
plague.

Its usual exciting causes are to be found in a peculiar state of the
brain or of the stomach: and hence Dr. Crichton denominates the
two species, which he has introduced under it Incubus, cerebralis and
gastricus.

The term mare, in night-mnre, is perhaps immediately imported
into our own language from the Runic or Sclavonian mythology, in
which mara s:giiiti;^s a frightful spectre, damon, goblin, or night-hag,
whence the Anglo-Saxon name of £//"-sidenne. Yet the root of the
term is to be sought for in a still higher source, and a source which
has ramified with slight variations of meaning over most parts of the
world. "ID (fnar,) in Hebrew, imports " bitter, grievous, mischie-
vous, oppressive," " a mischievous, revengeful, oppressive spirit :"
whence TlD (marar, in Lat. nmror, amarus) " overwhelming weight,
bitterness, or oppression," '- bitter pangs." And hence in Persian and
Arabic mar-den. '■'■ to sink under the weight of bitter pangs or afflic-

GE. IV.J NOSOLOGY; (]9

Ephialtes terLiana. Smiv.
2. NOCTURNUS. Produced during sleep, and interrupting it with
violent struggle and tremor ; the pressui'e on
the chest seeming to be that of some hideous
monster or phantom.

Ephialtes. Sauv. Linn. Sag. Plouquef.

Incubus. V^og. Junck. Cricht.

Epilepsia nocturna. Gal.

Oneirodynia gravans. Cull.

Erethismus oneirodynia. Young.

Kabus. J rah.

Alp. Nacht-mannlein. G.

Cochemar. Incube. F,

Night-mare. In Anglo-Saxon, Elf-sidenne (Elf-squattmg.)
The last species found, occasionally, as a symptom in

dyspepsy, and other complaints of the stomach, hydroce-
phalus, worms, and hypocondriasis. Horses are said to

be subject to it.

GENUS V.
STERNALGIA.

Violent pain about the sternum, extending towards the
arms ; anxietj^, difficulty of breathing, and sense of suf-
focation.

Angina pectoris. Heherd.

Angina pectoris. Cull. Catal. Morhorum Omissorum quos
omississe fortassis non oporkhat.

Syncope anginosa. Dune. ann. 1800. Parry,

Asthma dolorificum. Darw.

Brustbraune. Eisner, See Com?n. Lips. vol. xxxiii.

tion," " to be extinguished or die." Hence in Greek f^ot^x {moir-a,)
" fate," fci^iett (mor-ice,) the " destinies or destroying deities ;" and
M«gos, [mor-os) " death :" whence again, besides mar-or^ the Latin
terms mor-i, mors of the same meaning ; and in German mahre^ " a
gobhn-tale or ghost-tale, a tale of fictions and phantoms," of appari-
tions or fancies, or any thing unembodied or visionary.

Gen. V. Sternalgia. From a-rt^vov, " sternum," and xXyeii '•'• do-
lor." There are feiv diseases concerning which we are able to
reason so little. Dr. Heberden has the credit of having first brcughr
12

90 NOSOLOGY. [CL. II.-OR. II.

1. AMBULANTiuM, Supervening Suddenly during excFcise ; with

tendency to syncope ; relieved by rest.
Asthma arthriticum. Schmidt.
Diaphragmatic gout. Butler.

2. CHRONICA. The paroxysms less violent, but of longer conti-

nuance ; recurring frequently with great palpi-
tation of the heart, excited by slight, and often
unknown, causes, and not relieved by rest.
Orthopnoea cardiaca. Sauv.
Syncope cardiaca anginosa. Duncan,

At times combined with acrotismus, or cessation of pul-
sation. See Mr. J. Hunter's case in Entasia acrotismus*
CI. IV. Ord. iii.

GENUS vr.

PLEURALGIA.

Pungent pain in the side ; difficulty of breathing ; without

fever or inflammation.
Pleurodyne. Sauv. Sag. Macbr.

this afifection into public notice before the London College of Physi-
cians in 1768, though possibly he was not the first that observed it;
for the passage quoted by Dr. Letherland in the Edinburgh Medical
Commentaries^ Vol. iii. p. 180, from Poterii 0pp. cent. 3. n. 22, and
which is as follows, seems directly to allude to sternalgia ambulan-
tium : " Respirandi difficuUas quae per intervalla deambulantibus in-
cidit : — hi ut plurimum derepente moriuntur." It seems also to be
referred to by Hoffman in his Consnltationes Medicce, and occasional-
ly bv Morgagni. By many writers it has been ascribed to some dis-
ease, of the heart, as spasm, accumulation of fat, polypous concre-
tions, ossification of the coronary arteries, or affection of the valves;
while some have referred it to a spasm of the diaphragm, and other
muscles of respiration. Probably both may be regarded as causes
in different instances ; for that the heart is not always affected, is clear
from the frequent regularity of the pulse through the entire parox-
ysm. From the cases that have occurred to the author, the respira-
tory organs seem to be the seat of spec. 1, and some affection of the
heart, of spec. 2.

Gen. VI. Pleuralglv. From TrXtvftt, " latus," " membrana costa;?
auccingens," and «Ay«5, " dolor." Dr. Cullen has regarded pleural-
gia, or pleurodyne, as merely symptomatic of some other disease,

«E. Vf .] NOSOLOGY. 9 1

Antalgia dolorosa. H. Young.
Mum. Arab.
Seiten-stiche. G.
Stitch. Pain in the side.
1." ACUTA, Sudden and temporary; supervening on muscular
exercise ; relieved by pressure.
Pleurodyne a spasmate. Van. Swiet. Sauv. Macbr.
2. CHRONICA. Permanent : augmented by pressure ; inability
of lying on the side affected.
Pleurodyne parapleuritis. Veziani. Sauv.

The first species found also frequently as a symptom in,
flatulence, hysteria, and hypocondriasis. The second in
plethora, worms, syphilis, phthisis, rickets, catarrh, and
rheumatism.

and for the most part of rheumatism ; and consequently, it has no
place in his system of nosoloa^y : and the example he has set has
been followed by most later writers of our own country. The spe-
cies here offered, however, seem to have a fair claim to be regard-
ed as strictly idiopathic. The second, indeed, is frequently a conse-
quence or sequel of pleuritis, though not always so : yet even when
it is, the disease is altogether distinct from pleuritis, and must no
more be confounded with it than chronic with acute rheumatism ;
the former of which Dr. Cullen regards as a sequel of the latter,
but still entitled to a separate notice and definition.

Van Swieten and Sauvages, in denominating pleuralgia acuta, pleu-
rodyne a spasmate, make a difference between spanna and spasmus :
*' Spasma non est spasmus, sed distractio, divulsio,qualis accidere so-
let a vehementi musculi nisu, contractione, extensione, ut inter luc-
tandum, onera gestanda, currendum." Vide Van Swiet. Com. in aph.
C75. Sauv. i. 684.

Darwin ascribes the chronic species in many cases, and especially
among young ladies of delicate habits, to the use of tight stays,
•which, by their pressure, weaken the action of the vessels compos-
ing some membranous part. 1. i. 2. 14. — The common siitch in the
side (acute or transient pleuralsfia) is produced by too great and
sudden distension of the same vessels from propulsion of blood in
running or other violent exercise. It is hence relieved by a tight
bandage, which equally supports the vessels, and diminishes the cur-
rent of blood by its pressure ; and subsides on rest, or even slacken-
ing the pace.

CLASS III.
H^MATICA.

1>1SEASES OF THE SANGUINEOUS FUNCTION.

ORDER I.

PYRECTICA.

FEVERS.

Heat and number of the pulse preternaturally augmented x
asuall J preceded by rigor, and followed by perspiration ;

Class III. Hjematica. 'AtftxTixet., " ad sanguinem pertinentia,"
from utfiet, " sanguis."

Okdeii I. Pyrectica. nv^iKTiy.et, " febrilia," from ;rt>g8T»s, " igneus
aestus," " febris," as this is from urt/^, " ignis."

Pjrectica is here used in its fullest collective sense, and conse-
quently as importing TioavjfAoiToe. ^v^MTiitx, or 5rt»f«T«, " febres," or
" morbi fobriles ;" terms better understood perhaps by themselves
than by any definition that has ever been offered. In reality no
writer seems to have been fully satisfied with his own definition ;
and it is not extraordinary, therefore, that he should seldom have
given satisfaction to others. The diflticulty proceeds from the com-
plexity of the symptoms that enter into the character of a fever,
the contrariety of many of them to each other in dilTerent stages of
it, and the occasional absence of some that in other instances ap-
pear to constitute its leading features.

That there is a change in the heat, or in the pulsation, or in
both, from their natural state, appears to be assented to by every
writer; but the extent and quality of this change has been a perpe-
tual source of controversy. Galen modestly declines engaging in
the latter question, so far as it relates to the heat of the body, and
merely handles it in regard to the pulse. Fever therefore, accord-
ing to him, is "a change of tho natural heat (innati caloris^y or a

CL. III.-OR. I.] NOSOLOGY. 93

pains fixed or wandering ; lassitude 5 debility of mind, and vo-
luntary muscles.

declination to a preternatural state, with a quicker and stronger
pulse." Fin. Med. p. 146. Vogel gives up the pulse, and fixes
pathognomically upon the heat; defining fever to be a " preterna-
tural increase of internal heat :" to which he adds, " dryness of the
mouth and heaviness of the body. ' Bianchi is afraid of advancing
as far as either of these. In opposition to Vogel he abandons the
heat, and hesitates to determine concerning the altered state of the
pulse, merely admitting that t'.ere is an alteration. Under Bianchi's
bands therefore fever is " a change of the pulsation, with a painful,
peculiar lassitude of the whole body, and a sudden debility of the
voluntary muscles.'' Hist. Hep. p. 847.

Sennert distinguishes fever by increased heat alone ; Sylvius, C.
Boerhaave, and Darwin, hy increased quickness of the pidse alone ; H.
Boerhaave by both these symptoms, preceded by horripilation or
shivering (Aph. 663 :) while Cullen, in addition to the symptoms of
shivering, increased heat, and quickness of the pulse, subjoins, " in-
jury of various functions, especially diminution of the strength of
the limbs." This, however, it should be farther observed, is CuUen's
definition of pyrexy as a classific, and in some sort an abstract term,
under which he has made fevers a distinct order; for he afterwards
defines fever as an actual disease, to consist in preceding languor,
lassitude, and other signs of debility, with pyrexy, (or all the above
symptoms ascribed to pyrexy,) without primary local disease. Sau-
vages, who furnished Cullen with most of his symptoms, adds what
Cullen has omitted — " madore in declinatione," " svveat in the de-
cline of the paroxysm." Fordyce who has perhaps refined some-
what too much, has correctly suggested, that some notice should be
taken of the state of the mental powers, these being always in some
degree weakened or disordered: a suggestion on which Dr. Clut-
terbuck has founded his ingenious hypothesis of fever, which he
regards as "consisting essentially in topical inflammation of the
brain or its membranes," and consequently as being " neither more
nor less than a species of phrenitis ;" while Dr. Parr, bending also
to the authority of Fordyce, has introduced into his definition, which
is chiefly however drawn from Cullen. the symptom of " mind un-
steady," to which he has added, " tendons of the wrist tense."

The fullest of these definitions is, after all, that of Cullen ; but
it is somewhat wanting both in elegance and precision. Without
farther inquiring into the propriety of using pyrexy in a sense diffe-
rent from most former, and many subsequent, writers, upon which
the author has already observed in the Introductory Dissertation, it
must be clear that a term selected as the appellation of a class, ought
to have no place in the definition of an order that constitutes one of
its divisions; for whatever is contained in the class is necessarily im-
plied in every order that occurs under it. In arranging fevers

^4 NOSOLOGY. [CL. IlI.-OR. I.

The two most striking characters of fever are heat and in-
creased or violent action. In most languages the name for the

therefore as an order belonging to the class p}'resies, and then enu-
meratinsf pyrexy as one of the leading features of fevers, Dr. Cullen
evinces an inelegant and immethodical tautology. Yet the same
tautology is continued through most of the other orders of the class,
for one of the characters that enters into the definition of haemorr-
hagiae and protluvia, and even ot" the genera of several of the or-
ders as phlogosis, phrenitis, pneumonia, catarrhus, and various
others, is still pyrexia, while the classific appellation of pyrexiae is
uniformly preserved and printed as the running-title to the whole.

Dr. Cullen has, moreover, been accused of imprecision, as well
as of tautology, in introducing into his definition of pyrexies symp-
toms which do not always occur in the different genera he has ar-
ranged under this class, asstiivering (^horror,) and frequency of pulse.
It was a frequent objection made during his lifetime ; and he replies
to it as follows: " That pyrexies of this kind are sometimes, though
very rarely, to be seen, I will not deny ; but in laying down the
characters of classes for the distinction of species, it does not seem
necessary that all the marks of a class should be discernible in eve-
ry one of the species ; and it is sufficient that the greater number
of them should be present in each.''

This defence is hardly admissible; and its introduction into prac-
tice would be a source of the greatest looseness and confusion. The
character of a class, or of an order, cannot be too simple, provided
it be sufficiently discriminative ; and if any of the genera or species
intended to be arranged under it, do not develop such simple and
discriminative mark, instead of forcing them into a situation to
which they do not belong, another class should be made for their
reception ; or (which however is less advisable,) the objectionable
clause in the general character should be qualified by plerumque^ or
some such term, to allow them an admission.

The chief objection to the simpler of these various definitions is
its looseness; the term change, whether api)lied to the pulse or
the heat, gives no idea of the nature of the change, and consequent-
ly no idea of the precise character of the disease. If with H. Bo-
erhaave and Cullen we define the change in each from what occurs
most prominently ; if we provide for the occasional absence of the
introductory rigor, or col<l and shivering, by some qualifying ad-
verb, as " usually," or '' for the most part," and notice that debility
of the mind on which Dr. Fordyce has so justly insisted, we shall
perhaps make as near an approach to correctness as can be accom-
plished, it seems unnecessary to .provide against the very (ew
cases that are supposed to occur of no augmentation in the heat
or pulse ; for admitting their existence, they are confessedly ano-
malous, and have no need therefore to be guarded against under u
general rule

CL. 1II.-0R. I.] JN[OSOLOGY. 95

disease is derived from the former, as pyretiis in Greek, fehris
in Latin, calentura in Spanish, caldezza, in Italian, though both

The DIVISION of fevers has proved another source of difficulty
among nosologists. The distinctions which seem to be most obvi-
ous for this purpose, and which have been chiefly attended to from
the time of Galen to our own day, are the duration of the disease,
and its tendency to putridity. Sauvages, Linneus, and Sagar, have
principally adhered to the former ; Boerhaave, and most of the hu-
moral pathologists of recent times, as also Macbride, to the latter.
Other physicians have been more attentive to the range or locality
of fevers, as being epidemic, endemic, or sporadic. J' his last was
a favourite view of Hippocrates ; and Sydenham, who has so close-
ly followed him in other respects, has had his eye also constantly
directed to this kind of division. Darwin has endeavoured to ar-
range fevers according to the nature of their influence on the sensi-
tive or irritative fibres ; he supposes them to be of five kinds ; by
kinds, however, meaning species, two of which are diseases of irri-
tation, and three of sensation. Yet not quite satisfied with this
arrangement, he immediately afterwards doubts whether the whole
ought not to be placed under another class of his system, among the
diseases of association. Of all arrangements therefore this is un-
questionably theworst ; it is built altogether upon hypothesis, and
scatters a natural family of diseases over every part of the classifi-
cation.

Dr. Cullen, whose constant and laudable object was simplicity^
and who, whenever he has failed, has only failed from pressing this
object too far, conceived that all fevers might be resolved into the
two kinds of inflammatory and nervous, objecting, however, to the
use of these terms as entirely theoretical. His division therefore
is founded upon this view, and is indubitably possessed of great
merit. " Aliam divisionem," says he, " a diff'erentia symptomatum,
et a natura morborum, qnantum de ea jndicare liceat, desumptam,
institui : secutus simul illam apud Brit;innos nunc maxime usitatam
divisionem febrium continuarum in hiflammatorias, et JYervosas.
Has, autem, appellationes, utpote quodammodo theoreticas, vitavi."
It is nece'ssory to observe, that the term nervous is here employed
merely in its popular sense ; a sense which seems to have been
first made use of by Willis, De Morb. Convuls. cap. viii. ; for the
physiological principles of Cullen induced him to regard every fever
as strictly a disease of the nervous system ; and half tempted him
to transfer the whole family to his class of neuroses, or nervous
diseases.

After all, however, this aim at a simplicity unknown to former
writers, has not answered ; for Dr. Cullen, instead of confining him-
self to two genera, as he seems at first to have intended, has given
us six, besides an appendix for Hectica ; while he has still found it
necessary to marshal these six under sections and subsections of in-

96 NOSOLOGY. [CL. IlI.-OR. 1.

the Spanish and Italian writers frequently concur with the
French, English, and Germans in employing a modification of

termission, remission, and continuity, together with a complex and
intricate machinery of minuter partitions; by which means he has
fallen int© the very scheme of distinguishing the difli'erent kinds of
fever by the obvious sign of the ordinary duration of the disease,
which it was his expressed object to avoid; and at the same lime
has rendered the subject more complicated than perhaps any other
nosologist, with the exception of Darwin. It is hence not to be
wondered at that few later writers have followed Dr. CuUen in this
part of his method ; and that most of them have returned to the ge-
neral character of duration.

Under all the forms of fever, indeed, even those that are most
complicated, duration seems to constitute its chief feature. In its
simplest shape, as that of an ephemera, or the first paroxysm of a
quotidian, its pathognomic distinctions are few and striking, and here
its duration may be calculated with tolerable accuracy. However
violent, it is here a simple disease ; consisting of a single fit of three
distinct stages ; shivering, heat, and perspiration, each most proba-
bly, as Dr. Cullen conceives, dependent on the other, and ceasing,
when true to itself, after having followed up the movements of the
animal frame through a single diurnal revolution. In the ephemera,
however, the cold stage is often scarcely perceptible, and at times
altogether imperceptible ; and in the quotidian a predisposition or
tendency to return is established from the first, producing a regular
duration of intermission and of paroxysm, 'i his predisposition or
tendency differs in different cases, from habit, idiosyncracy, or cli-
mate ; and hence the durations are ditferent, whether of paroxysm
or of interval : and hence again the origin of the various types of
tertians, quartans, quintans, sextans, &c. as well as of quotidians.
While in other cases the tendency is duplicated or multiplicated, and
we behold two or more sets of quotidians, tertians, or quartans run-
ning on at the same time, producing paroxysms daily, or oltener
than daily ; each set or type being distinguished from the rest by the
similarity of its own paroxysms, and its diversity from those that are
intermediate. — Sometimes the intervals are perfectly free from fe-
ver, and in this case the disease is strictly intermittent ; and some-
times the paroxysm i^ protracted, and does not perfectly cease be-
fore the arrival of the next in rotation. If, in the last case, there
be a decided and regular diminution, though without a total cessa-
tion of fever or pyrexy, the' disease becomes a remittent ; but if the
remission be less obvious and regular, it forms what is called a con-
tinued fever ; a tendency to remit, intermit, or cease at particular
I)eriods, or after particular durations^ still running through its whole
course, and constituting critical terms or days.

Admitting duration, then, to be (he most convenient basis for the
division of fever, we should unquestionably commence with the

CL. III.-OR. I.] NOSOLOGY. 97

the Latin term. In Anglo-saxon the name is derived from the

ephemera, or simple fever of Fordyce, a disease acknovvledged by
all writers, but unaccountably omitted by several, and huddled by
others into the varieties or synonyms of some other genus. The au-
thor's late learned friend, Dr. Parr, in his valuable dictionary, has
written a short but good article upon this disease, under its proper
name ; and with his accustomed acumen, has marked two species of
it; but has strangely dropped it in his article on Nosology. It is con-
tinued by Dr. Crichton, but omitted by Dr. Young. Fordyce has set a
valuable example upon this subject, as ^vcU in beginning with the
ephemera, as in treating of it with great clearness and precision,
though possibly with too much digression. In a few cases of ephe-
mera, he has seen it happen, he tells us, that the disease has con-
tinued thirty-six hours; and in one case above forty hours from the
attack to the termination of the crisis, or perspiring stage, but this
very rarely. On Fever, Dis. iii. p. 59.

The ephemera, moreover, has hitherto been seldom properl}'
defined or limited, even by those who have employed the division.
Most of the writers have allowed it to embrace all fevers that cea?e
within half a week ; in consequence of which it is ranked by Sau-
vages under his ordinal division of ye6res continuce, and made to in-
clude milk-fever, the ephemera lactca of Riverius, and various others
with which it has as little connection; whilst Crichton has mar-
shalled under its banners vaccine fever and nettle-rash. Avicenna
appears to have had the justest notion of its proper nature and
limit, and the first two species of the present system are chiel^'
dravifn from his description and boundary. Dr. Fordyce has been
equally alive to the proper range of a diary fever, and is equally
worthy of attention. The third species, g sudatoria, if retained at
all, must fall necessarily into the place here assigned it. In natural
history it is not usual to continue genera or species that have ceas-
ed to exist ; but it is often ditficult to determine what have ceased
to exist: and we are not altogether free from this difficulty in the
present case. The Sueating-Sickness made its first appearance in
London in 1485; where it took up its abode with various intermis-
sions of activity for nearly forty years; it then visited the continent,
overran Holland, Germany, Belgium, Flanders, France, Denmark
and Norway, among which countries it continued its ravages from
1525 to 1530 : it then returned to England, and was last discovered
in 1551 : possibly originatmg from inclement harvests and vitiated
grain ; but being more probably a peculiar contagion that has long
since worn itself out, and become decomposed ; though it may still
be latent, and only wailing for its proper auxiliaries once more to
show itself in the field.

The general arrangement of Linneijs, S;invnges, and Sagar, is into
continued, remitteni, and intermillent levers, each of which consti-
tutes a distinct order. More correctiv thev ought only to constitute
13

1)8 NOSOLOGY. [CL. III.-OR. I.

second of the above characters, and is drif^ or emphatically
ge-drif; though the lormer is mostly used in Bede's Bible. The

so many genera ; and under this more simple form we find them in
Galen, de Diff. Febr.^ who gives them the names of mtermittens,
synocha, and synochus : and it is to this form the present system
adheres, though the Galenic names are changed.

The subject of names has, indeed, bfen another difficulty of no
small magnitude among nosologists. The three genera of Galen
having been transformed into so many orders by later writers, his
names of synocha and synochus have been made to assume a new
and more limited sense, by being confined to genera under such or-
ders, but which, in Galen's own arrangement, had it been carried to
so much minuteness, would have been, and ought only to be, spe-
cies. Thus synocha among writers of modern times is generally
employed to signify inflammatory fever^ probably the synochus non
putridus of Galen, and synochus, putrid fever, probably the synochus
cum putridine ; while the original and more extensive senses of sy-
nocha and synochus are expressed by febres remittentes^ and conti-
nentes, or febres exacerbantes, and continuce, " remitting and conti-
nent," or " exacerbating and continual fevers."

The wh'jle of this can be called little less than jargon. Synecha
and Synechus were bad names from the first ; they were bad in the
Greek, as wnxnit or (rvte^^vi (for it is written both ways,) and ffvmfcot ;
but they are still worse in the Latin, being constantly liable to pro-
duce mistake from their close resemblance to each other; while,
moreover, they are nothing more than the same words possessing
the same radical meaning, with a slight variation of termination :
and in their Latin form with a still slighter variation than in their
Greek ; for synocha only differs from synochus as being its proper
feminine.

But if, on these accounts, they were bad terms as employed by
Galen, they are altogether absurd and intolerable as employed
among recent nosologists. Under the hands of Galen they had a
radical and proper meaning, that of continuity, from avvixu, to conti-
nue, synecha importing imperfect, and synochus perfect continuity :
and even when first applied to signify inflammatory and putrid fe-
ver, they still kept some reference to the same idea; for the na-
ture of their respective continuities enters into the definition of
each of them as laid down by Linneus and Sauvages; but this mark
IS totally lost sight of by Dr. Cullen, who hereby employs terms
merely importing continuity as the names of diseases in which con-
tinuity does not form any part of the character which he applies to
them. To add to (he general confusion, while Sauvages, Linneus,
and Cullen, use synocha to signify inflammatory fever, and synochus
putrid fever, Vogel uses synochus for putrid fever, and makes no
mention of synocha. In like manner, the terms intermittent and

GE. I.] NOSOLOGY. 99

radical idea of this term is force, impulsion, violen? action : it
is the root of the English, drive, drift.

GENUS I.

EPHEMERA.

Attack of fever sudden ; paroxysm single, and terminating ,
in about twenty-four hours.
Febris continua simplex. Macbr.
Febris ephemera. Plouquet. Fordyce, vol. ii. p. 22.
Eintagages fieber. G.

continent have been used by different writers in highly different
senses : intermittent commonly as importing intervals of perfect apy-
rexy, as the Greeks, or infebricitation, as the Latins called it ; but
by Dr. CuUen as importing intervals of mere remission^ as well as of
perfect apyrexy or intermission, while the term continent is employ-
ed sometimes in the general sense of continued fever, or fever ad-
mitting of occasional remissions m the midst of a continued course,
which was its more common signification ; sometimes in the limited
sense of continual fever, or fever running its course without the
slightest remission or relaxation from the beginning to the end, a
meaning given to it by Stahl and iSennert ; and sometimes, as by
Morton, in his Pyretologia, in the sense of remitting, being precise-
ly synonymous with this last term as used by Huxham and Pringle.

Some common understanding therefore, and consequently some
change, is become absolutely necessary : and it seems impossible not
to approve the banishment of synocha and synochus, as has been
done by Dr. Fordyce and various other pathologists, as well as by
Sagar, Macbride< Parr, and Young; and the limitation of intermit-
tent to its strict sense, as in the hands of Macbride, Parr, and Crich-
ton.- The present system follows this example, anetus, epanetus,
and enecia, being used synonymously with the febris intermittens,
synocha and synochus of Galen, or the febres intermittentes, remit-
tentes, and continuae of modern writers. Dr. Young has anticipated
the author in employing anetus, but in a different sense ; for he uses
it, though as a single genus, to embrace equally intermittent and
remittent fevers ; and hence synonymously with the whole section
of intermittentes, as employed by Dr. Culien.

Gen. I. Ephemeka. Efnf^i^x, " diaria," from g^r*, or 'iw', " apud,"
and ijjitip*, '* dies."' We have no classical authority, however, for
using it as a substantive, though we are justified by analogy. Galen
writes usually t<p*ifnfes 5r«geT#;, " diaria febris."

100 NOSOLOGY. [CL. III.-OR. I.

Courlfaturc. F.
Simple Fever. Fordycc^ passim.
Diary Fever.
1 . MiTis. Without preceding rigor ; heat and number of the
pulse increased slightly ; lassitude and debility
inconsiderable ; pains obtuse, chiefly about the
head ; perspiration breathing and pleasant.
Ephemera. Lommii. Sauv, Cricht.

Usually produced by excess of corporeal exertion,
study, or violent passion : by suppressed perspiration ;
sudden heat or cold.
■2. ACUTA, Severe rigor; great heat; pulse at first small and
contracted, afterwards quick and strong ; perspi-
ration copious ; great languor.
Ephemera. Par. It occurs in his alphabetical arti-
cle, but is not noticed, as it ought to have been, in his ar-
ticle " Nosology."
Ephemera plethorica. Sauv.
Ephemera nauseativa. Avicenn. Sauv.
Diaria inflativa. Auct. Far.
Synochus Ephemera. Fog.

Frequently produced by a surfeit of eating or drink-
ing ; or some temporary organic obstruction : more com-
monly by unknown causes.
3. SUDATORIA. Tense pains in the neck and extremities; palpi-
tation ; dyspncea ; pulse rapid and irregular ;
heat intense ; intolerable thirst : droAvsiness
or delirium ; excessive sweat.
Ephemera sudatoria. Sauv.
Ephemera maligna. Jurtck.
Ephemera anglica pestilens. R, Fort.
Hydronosus. Forest,
Sudor Anglicus. Sennert,

3. Ephemera sudatoria. Supposed by Wilian to have been the
result of some depravity in the wheat made use of in our own
country at the period of the disease, which was the beginning of the
sixteenth century. In proof of which he observes from other sour-
ccF, that the contemporary inhai)itnnts of Scotland and Wales, who
fed on oaten or barley instead of wheaten bread, were not affected.
A similar disease appears to h:ivo existed soon afterwards (1525) in
Denmark, Norway, Holland, Finnders, and various parts of Germa-
ny. Forest, de Febr. p. 157. Sinner, iv. and xvi.

See Lord Bacoii's description of the sweating sickness, Hist. Hen.
VII. p. 5. Wcdel Dc Sudore anglico. .Ten. 1G97. Haller Ribl. Med.

UE. II.] NOSOLOGY. iOI

Schweyssucht. G.
Suette. F,
Sweating-sickness,

GENUS II.

ANETUS.

Paroxysm intermitting, and returning during the course of
the disease : the intermission generally perfect and
regular.

Febris intermittens. Gal.

Febres intermittentes. Sauv. Linn. Fog.

Intermittens. Parr.

Abwechselnd-fieber. G.

Fievre intermittente. F.

Ague. — Intermittent.
1. QUOTiDiANUS. Intermission about twenty-four hours : parox-

Pract. i. Bayer, Hathschlag der jezl regierendon Pentilens, so mar
den Englischen Schweissnennt. See also the note on Pyrectica.

Gen. II. Anetus. 'A«t«j, from Kmf*i, " intermitto," " solvo,'"
" intermissio vel solutio omnis imperii," as cenrsj t^ov(7ix r*y trr^xrtM-
ru*. Herodian. In like manner Epanetus (s»r«i»eTaj,) from ejravoi^*^
" remitto."

Dr. Cullen, as already observed, unites intermittents and remit-
tents into one section of fevers, merely distinguishing them as inter-
mittents with an interposed apyrexy, and intermittents with remis-
sion alone ; and he makes it a part of their pathognomic character
that they are derived from raarsh-miasm, miasmate paludum ortoe ;
whence Dr. Young gives to these two sorts of diseases the name of
paludal fevers.

The present system is intended, not to support hypotheses of any
kind, however plausible, but to rest, as far as may be, on physiolo-
gical facts. Marsh-miasm is unquestionably the grand source of both
intermitting and remitting fevers; but it is at present too much to
say that it is the only source. Even in tertians Dr. Cullen himself
is obliged to admit of instances in which other agents are necessa-
ry ; but then, says he, they are only co-agents, and would not ope-
rate alone : " has potestates excitantes pro parte principii hie admit-
timus, licet neutiquam morbum excitassent, si miasma paludum non
antea applicatum fuisset." But this is the very point of contro-
versy.

102 NOSOLOGY. [CL. III.-OR. 1.

ysm commencing in the morning ; usual
duration under eighteen hours.
Cathemerus (K«^«^fpo5.) jiuct. Grcec.
Quotidianus. Jluct. Lat. et Recentior.
Tagig-fieber. G.
Fievre quotidienne. F.
Quotidian ague.

H Partialis. The disease confined to a particular part or
organ, usually accompanied with distressing pain.

Sometimes limited to one side. Saun. sp. 10.
Cnoffetlia Collect. Acad. iii. 166. Ed. Med. Ess. u
art. 31. ii. art. 19.

Sometimes limited to one or both eyes, as in the
ophthalmia febricosa. Sauv. sp. 23. Quotid. oph-
thalm. Mor(. Pyret. exerc. i. hist. 27. Van. Swiet.
in Boerh. p. 534.

Sometimes, and still more generally, confined to
the whole or half the head, embracing many cases of
cephalaea. See CI. IV. Ord. iv. Gen. v. Cephalalgi-
ca intermittens. Sauv. sp. 7. Cephalaea febricosa,
sp. 23.
S Comitatus. Catenated with, or giving rise to, foreign
symptoms or oiher diseases. Constituting the family
collected by Torti under the name o^ febres intermit-
tentes comilatce : to which belong the following:
Ischiadic quotidian, or intermittent ischias, Sauv. Quot.

sp. i. Isch. s . 5. Ed. Ess. v. art. 49.
Nephralgic quotidian, or febricose nephralgia. Sauv.
Quot. sp. 7. Nephr. sp. 13. Mort. Pyr. ix. hist. 28.

If intermittent ouo-ht to be separated from continued fevers, so
ought remittent to be separated from intermittent. To say that in-
termittents often run into remittent? is to say nothing', for remittents
as often run into continued fevers: and it is now an estabUshed doc-
trine, that there is no continued fever whatever witliout occasional
remissions. In effect, all fevers have a tendency to run into each
other, and many causes are perhaps common to the whole. The
dithculty is in drawing the hna : yet a liUe difiiculty is perpetually
occurring to the phvs ologist in every part of nature; and equally
calls for discrimination in zoology, botany, and mineralogy : and Dr.
Parr has correctly ohs rved, that 'if a specific distinction can be
established in any branch of natural history, it must be so in the se-
paration of remittents from inteimittents." Vogel unites remittent
with continued fevers, to wbich Cullen objects, and unites them
with intermittcnts. Sauvages, Linneus, Sugar, and most modern
writers, more correctly distinguish each from the other.

«E. II.] NOSOLOGY. 103'

Epileptic quotidian. Sauv. Quot. sp. 4. Ed. Ess. ut
supr.
y Protiac tus. Leaving the intermission inordinately short,
or imperfect.
Amphemerina. Sauv. Embracing many of his species.
i Anticipans. 'ihe paroxysm anticipating its antecedent
period usually by about two hours : and continuing
the same anticipation at every recurrence ; so that
the accession may hereby be thrown into any hour of
the day or night.
Anticipating quotidian. Fordyce.
t Cunctans. The paroxysm delaying its antecedent
period, usually by about two hours; and continuing
the same delay at every recurrence as above.
Retarding quotidian. Fordyce.

The quotid an is also occasionally found, as a symp-
tom in hysteria, catarrh, gout, peripneumonj', ischury,
quinsy, and various other diseases.
2. TERTiANUs. Intcrmission about forty-eight hours : paroxysm
commencing at noon ; usual duration under
twelve hours.
Tritaeus. Auct. Grcec.
Tertianus. Auct. Recentior.
Hemmai mushelleshe. Arab.
Drey-tagig-fieber. G.
Fievre tierce. F.
Tertian ague.

» Comitatus. Catenated with, or giving rise to, foreign

symptoms or other diseases. 1 he chief of which

are the

Choleric, or dysenteric tertian. Tort. Therap. Spec.

Laut. Hist. Med. cas. 6, 16, 17, 20. Mort. App. ii.

Atrabiliary tertian. Tort. ibid. Sauv. Tritaeoph, sp. 4,5.

Syncopal tertian. Tort. Laut. Sauv. Tritoeoph. sn. 1.

Lethargic tertian. Tort. Triiseoph. carotic. Laut.

Sauv,

4. n A. Erraticns Vagus. It is probable that various forms of he-
micrania belong to this variety : those more especially which origi-
nate in low, damp, or marshy districts, which return more or less
regularly, and are relieved by the bark alone, or in conjunction
with warmer tonics. Several of Sauvages' species of hemicrania
may be properly referred to this place ; and especially those which
by some writers have been denominated iniermitteiites larvatxe^ or
disguised interraittents.

104 NOSOLOGY. [CL. III.-OR. I.

Tertianus apopleclicus. Mort. T. soporos. Werlhof. de
Febr. 6.
C Protractus. Leaving the intermission inordinately
siiort or imperfect.
Tritaeus. Lin7i.

Tertiana (febris) subcontinua. Sauv.
Tritaeophja. Sauv. Sag. in several of the species.
Tertianus remittens. Auct.

The species is found also, occasionally, as a symp-
tom in syphilis, sea-scurvy, worms, and scabid
eruptions.
3. QUARTANus. Intcrmisslon about seventy-two hours; parox-
ysm commencing in the afternoon ; usual
duration under nine hours.
Tetartaeus. Auct. Grcec.
Quartanus. Auct. Recentior.
Hemmai murbau, whence the patient is denominated

murbua.
Vier-tagig-fieber. G.
Quartaine. Fievre quarte. F.
Quartan Ague.

16 Comitatus. Catenated with, or giving rise to, fo-
reign symptoms or other diseases: of which the
chief are the following :
Comatose quartan. Sauv. WerUiof. Parr.
Cataleptic quartan. Sauv. Bond. Polyalth. i. 805.
Neophralgic quartan. Sauv. Lcmer. Journ. des Sa-
van?.

5 ee. Aneitis complicatus. Intermittents (chiefly tertians) have
often proved the best remedy for chronical diseases; mostly in their
simpler forms. Menorrhagia has been cured by a tertian. Ephem.
JVat. Cur. Dec. II. ann. vii. obs. 213. See, for other examples. Car-
dan. Contrad. Med. i. 1. Tr v. n. 15. — Tertian itself carried off by
catamenia. Eph. Nat. Cur. Dec. I. ann. vii. obs. 213. — Another in-
stance in Madai., von Wechsclheborn. § 203. " It has been often
observed," says Fordyce, " that regular tertians clear the constitu-
tion of all other diseases, and certainly on a good foundation." He
instances particularly the cases of chronic rheumatism ; habitual in-
digestion ; cutaneous eruptions; protracted inflammations; epilep-
sy ; and hysteria. "• In many of these cases such diseases are alle-
A'iated, though not entirely carried off." On Fever., Disii. ii. p. 16. —
Sonietimcs produced by vvorms, and only removed by vermifuges.
Hunter on Blood, p. 4 1 1 . — Sometimes by diseases of the liver, spleen,
or mesenteric jrlands. Id.

GE. H.] NOSOLOGY. 105

Idiotic quartan. Sydenh. de Blorb. Acut. v. Sanv.
S Protractus. Leaving the. intermission inordinately
short, or imperfect.
Tetartophya (febris.) Sauv. Linn. Sag. in several

of the species.
Quartanus remittens. JJuct;
y Anticipans. The paroxysm anticipating its ante-
cedent period, usually by about two hours; and
continuing the same anticipation at every recur-
rence ; so that the accession may hereby h6
thrown into any hour of the day or night.
.Anticipating quartan. Fordyce.
§ CunctanSi The paroxysm delaying its antecedent
period, usually by about two hours ; and con-
tinuing the same delay at every recurrence as
above.
Retarding quartan. Fordyce.

The species is found also, occasionally, as a
symptom in diseases of the spleen, liver, and other
abdominal organs.
4. EURATicus. Intermission and paroxysm less regular : the
former more than seventy-two hours.
Febris erratica. Sauv. Sag.
Febris errana. Linn.

The varieties, as given under the form of species by
Sauvages and Vogel, are the following :
« Quintanus. Tulpii. Aviccn. can. iv. l._^
C Sextanus. Vog.

2. Epdnetus malignus. For the origin of epanetus, see the note
on anetus. " Malignus discitur morbus qui 1""° invadit cum sponta-
nea virium prostratione : 2° cujus symptoma non respondent stadiis
morbi : 3" nee respondent signis externis, ut calori, urinae, pulsui.''
Sauv. i. p. 309.

The chief signs of putrescency are the following: the pulse quick
and tremulous ; heat of the skin sharp and pungent, giving to the
linger a peculiar feel for some minutes afterwards ; parched or wet
with sordid fetid sweat ; smell offensive at a distance ; breath hot
and fetid ; mouth aphthous ; tongue clammy, furred, livid, greenish-
hiack ; urine brown or blackish, and offensive ; stools blackish, col-
hquative, very offensive, parted with profusely and insensibly ; mind
wandering; twitching of the tendons; swelling and tension of the
belly ; petecchial spots, vibices, haemorrhages.

3. Epanetus Hectica. 'Ekt<««, from £|<?, " habitus." Nothing can
more fully prove the complexity and irregularity of this fever than
the different characters given of it, and the different places allotted

M

106 NOSOLOGY. [CL. III.-OR. I.

y Seplanus. Etmulleri. — Hebdom. Schenckii.
3 Oclanus. Amaii Lvsifani. — Octoman. Valesii.
t Nonanus. Zacnti Lusit.
^ Decimanus. Zacut.

Dichomene. Sauv. Ephem. dichomene. Deidier

Observ.
n Vagus. Equally irregular in the violence of the pa-
roxysm, the duration of its stages, and the period
of its return.
Quartana vaga. ElmuU.
5. coMPLiCATUS. Paroxysms intricate, multiplicate, or both.
«s Tertianus duplex. Double tertian ; the paroxysms of
the one tertian occurring in the intermissions of the
other ; and the two sets evincing a difference of dura-
tion or of violence.

The last sign determines their real nature ; and in
conjunction with their comparative brevity and time
of attack, (which, like that of the genuine tertian, is
at noon,) distinguishes them from the quotidian inter-
mittent ; for it is obvious, that from this interference
of the two sets with each other, the double tertian,,
like the quotidian, must have one paroxysm every
day.
Duplex tertians. Sauv.
Duplicana. Linn.
C Tertianus triplex. Triple tertian. Double tertian ta-
king place as above, but one of the sets having regu-
larly two paroxysms on the day of its return; the
other, one paroxysm alone.
Tertiana triplex. Sauv.

to it, by different authors. Sauvages and Sagar introduce it into the
list of continued fevers. Linneus, Crichton, and Parr, into that of
remittent or exacerbating fevers ; Boerhaave regards it as of a mixt
nature, a continued intermittent : " Fcbris hectica," says he, " est
referenda ad febrescontinuatas intermiltentes.'' Frax Med. iii. 337,
8vo. Vogel and Culien degrade it into a mere symptomatic affec-
tion. Under thi's last character it is perhaps most frequently to be
found ; but it is now generally adi. i*ted to occur at times idiopathi-
cally, or as an original disease of tlie rnnstitution. There are,
perhaps, few physicians of long or extensive practice who have
not met with it under this character: and those to whom it has ne-
ver thus occurred, may consult Mr J. Hunter's treatise on the
Blood, p. 496. 4to : as also Dr. Heberden's very accurate description
and history ; who seems, indeed, to place it in the rank of inlcrmii-

GE. III.] NOSOLOGY. 107

Semitertianus primi ordinis. Gal.
y Tertianus impar. Double tertian : the one set evincing
a more perfect, the other a less perfect, intermission.
Hemitrila'us. Cds. iii. 5.
Amphimerinus hemitritaeus. Sauv.
5 Tertianus duplicatus. Single tertian, with two parox-
ysms on the regular day of attack.
Tertiana duplicata. Sauv.
») Quartanus duplex. Double quartan : the paroxysms
of the one set occurring in the intermissions of the
other; with an intermission of the third day alone.
Quartana duplex. Saux.
(^Quartanus triplex. Single quartan, with -regularly
returning paroxysms ; each of the intervening days
being marked with a slighter or separate attack.
Quartana triplex. Vog.
t) Quartanus duplicatus. Single quartan, with two parox-
ysms on the regular day of attack.
Quartana duplicata. Sauv.
i Quartanus triplicatus. Single quartan,'with three pa-
roxysms on the regular day of attack.
Quartana triplicata. Sauv.

GENUS III.
EPANETUS.

Strikingly exacerbating, and remitting ; but without intermis-
sion : one paroxysm every twenty-four hours.
Febris remittens. Auct.

tents^ but only as he employs this term generally, so as, like Dr.
CuUen, to include a remittent action. CuUen gives us, as a pathog-
nomic symptom, " Urina sedimentum furfuraceo — lateritium depo-
nente :" while Hunter tells us that " the urine is pale." Dr. He-
berden appears to have attended to this circumstance very closely ;
and thinks that the same irregularity which accompanies most other
symptoms of the disease attends this also ; that the urine is equally
clear or turbid in the paroxysms and the intervals ; sometimes clear
in the first, and turbid in tlie second • and sometimes turbid in the
•first, and clear in the second. Dr. Duncan, from a long and assidu-
ous attention, has determined the character given in the text.

108 NOSOLOGY. [CL. III.-OR. I.

1. MiTis. Pulse regular, though frequent; debility slight; re- '

mission distinguished by sweating or a cloud in the
urine.
Remittens mitis. Parr.

2. MALiGNUs. Pulse Small, hurried, irregular ; debility extreme :

often with signs of putrescency.

Remittens maligna. Parr.
OS. AutumnaHs. Often with a strong tendency to assume,
the tertian or double tertian type.

Autumnal Remittent.
C Flavus. With yellowness of the skin.

Remittens icterodes. Parr.

Tritaeophya Americana. Sauv,

Typhus icterodes. Sauv. Cull.

American Yellow fever.

Said to be successfully treated by the root of the

ophiorrhiza Mungos, Linn. — Lee Amcsnit. Acad. vol. ii.

art. 21. on Lignum Colubrinum. J. A. Darelius.
y Ardens. Burning remittent-

Febris ardens. Bocrhaave.

Febris ardens periodica. Riv,

Causus (Knsucroj.) Hippocr.

Tritaeophya causus. Sanv.
S Asthenicus. Highly debilitating remittent of the south
of Spain, Gombron, Breslaw, &c.

3. Hectica. Pulse weak; stages of chilliness, heat and sweat

variously intermixed, and sometimes single ; the
Cold stage exhausting ; exacerbation chiefly in
the evening : urine Avith a nalant, furfuraceous
separation.

Hectica. Gal. Sydenh. Boerh. Sauv. Cull.

Febris lenta. Junk. Hoffm.

Amphemerina hectica. Cricht.

Dik. Arab.

Schwindsucht. G.'

Hectique. F.

Hectic fever.

In Vol. VIII. of the Amoenitates Acaflemicae, art. 171, there is a
good paper on the virtues of a species of St. John's-wort, Hypericum
perforatum, as an active antihectic. The article is by C. B. Helle-
nius ; and the plant is said to have been successfully employed by
Linneus, under the following- form : R Sumit Hyperici Manip. 1 —
eoque iu vini Hispan. lb. iv. ad lertiro partis rfman. cola.

GE. IV.] NOSOLOGY. 109

Found also, occasionally, as a symptom in tabes,
phthisis, chlorosis, lues, and scirrhous diseases of vari-
ous organs.

GENUS IV.

ENECIA.

One series of increase and decrease ; with a tendency to
exacerbation and remission, for the most part appear-
ing twice every twenty-four hours.
Febris continua. Boerh. et Auct. Recentior.
Febris continens. Starl. Juncker.
Hemmai daim. Arab.
1. Cauma. Heat greatly increased ; pulse quick, hard, and
strong; urine red; disturbance of the mind slight.
Synocha. Saiiv. Linn. Junck. Cull.
Febris continua sanguinea. Hoffm.
Febris continua non putris. Boerhaave.
Synochus. Fo^.
Synochus imputris. Gal.
Febris actua. Plouqnet.
Febris continens. Stahl. Plouqnet.
Continens non putrida. Lomm.
Febris inflammatoria. Auct. Var.
Hemmai mehrike. Arab.
General inflammation. Fordyce.
Injlammatory fever.

The dose two ounces, or a half-quarter of a pint, morning and af-
ternoon. The Swedish direction is JVwaraf ett halft quarter intages
morgan och afton.

1 he hypericum perforatum is a native of our own country as well
as of Sweden.

Gen. IV. Enecia : from *)y«j)?, " perpetuus," " continuus :" hence
Arist. Rhet. 1. 1, ijyixt*;^, " continua serie." Cauma {Kxvfcxj from xxta,
" uro"), is here preferred to synocha, for reasons already stated,
and especially as forming a hetter distinction from synochus. The
genus embraces the order " febres continuae" of Sauvages, with the
exception of ephemera and hectica ; and runs exactly parallel with
the genus " continua" of Parr. Sauvages characterizes the three
species of cauma (synocha,) typhus, and synochus, by a supposed

110 NOSOLOGY. [OL. IIl.-OR. I.

*t Plethoricum. Produced by the stimulus of violent pas-
sions, undue muscular exercise, or heating foods,
upon a plethoric habit ; as also bj a suppression of
accustomed discharges, as those of menstruation, ha-
bitual venesection, or porspiriiion.
Synocha plethorica. Sauv. CitIL
C Biliosum. Produced by the stimulus of an undue secre-
tion or absorption of bile into the sanguineous sys-
tem.
Synocha biliosa. Cricht,
Synocha ardens. Sauv.
y Pleuri ticum. Accompanied with a violent stitch or pain
in the pleura.
Synocha pleuritica. Sauv. Cull.
3 Cephalalgicnm. Accompanied with great pain in the
head ; and produced by a lodgment of worms or
the larves of insects (perhaps the oestrus ovis) in the
frontal sinus. See a curious case in Sauvages, i.
300.
Synocha cephalalgica. Sauv.

Found also, occasionally, as a symptom in empresma
(organic inflammation,), catarrh, severe local pain, la-
bour, and sea-scurvy.
2. TYPHUS. Pulse small, weak, and unequal ; usually frequent ;
heat and urine nearly natural ; great prostration
of strength, and disturbance of the mental powers.
Typhus. Hippocr. et Auct. Recent.
Typhodes. Prosp, Alpin.

diflference of specific, or, as he would call it, generic, duration : the
cauma terminating in a week at the farthest; the typhus in two,
though sometimes protracted to three, weeks ; and the synochus,
reaching beyond the second, and often beyond the third, week. In
our own country the most frequent form of the continued fever is
the synochus or mixt species. Dr. Cullen, in his Nosology, doubts
whether this should be regarded as a distinct genus from typhus ;
and observes, that it is difficult to assign the synonyms of authors if
we make it distinct. " Inter typhum et synochum limites accuratos
ponere non possum ; et an revera. pro diversis^renentHS habenda, vel
positis diversis, utri eorum synonyma auctorum referenda, sint, du-
bito." And in his First Lines, "■ I am disposed, ' says he, " to be-
lieve thai the synochus arises from the same causes as the typhus,
and is therefore only a variety of it." Part I. I. i. § 69. Yet out of
compliment to earlier writers he has continued it as a distinct genus.
Its proper place appears to be that in which it now stands, under
the ^dLvne iiemtn as typhus, but constituting a distinct specirs.

GE. IV.] NOSOLOGY. Ill

*t Mitior. With sUght shiverings; heavy vertiginous head-
ach ; oppression at the piaecordia; nausea; sighing;
despondency ; coma or quiet delirium ; urine whey-
like.

Typhus mitior. Cfill. Parr.

Typhus simplex. Cricht.

Typhus nervosus, sp. 2.— Comatosus, sp. 3. Sauv.

Febris lenta nervosa. Huxh. on Fev. ch. viii.

Febris putrida nervosa. fVintringh.

Febris hectica maligna nervosa. Willis.

Fievre nerveuse. F.

Nervous Fever.
Z Gravior. With rigor and heat alternating with little or
no perspiration ; pulse tense and hard, usually quick
but fluttering; pain over the forehead and crown;
urine alternating from limpid to turbid ; delirium suc-
ceeded by stupor: signs of putrescency.

Typhus carcerum. Saw. sp. 1. — Castrensis, sp. b.

Febris pestilens jEgypliorum. Alpin.

Febris pestilens maligna. Sennert. Willis, 1643.

Febris nautica pestilentialis. Huxh.

Febris carcerum et noscomiorum. Pringle.

Febris putrida. Xachr.

Maladie des Prisons — d'Hopital — de Geole. F.

Putrid fever ; Jail, Camp, Hospital fever.
3. SYNOCHUS. Compounded of cauniii and typhus : in its com-
mencement resembling the former ; in its pro-
gress the latter.

Synochus. Gal. Sauv.

Lenta. Linn.

It is, however, often difficult to arrange several of the species of
what are usually called remittent and continued fevers ; for the ex-
acerbations and remissions are sometimes of so dubious and obscure
a character, that we can scarcely determine concerning their exis-
tence : and hence the yellow fever of America and the West Indies
is regarded as of the continued kind by Sauvages and Cullen under
the name of typhus icterodes ; but as of the remittent kind by the
greater number of more recent writers ; in consequence of which
it occurs in the present classification under the name of Epanetus
malignus C, or flavus. Enecia Synochus €, or flavus, has, however,
a very near resemblance to it; and perhaps while the yellow fever
of the West Indies is referred to the first, that of North America
ought rather to be referred to the second. Sauvages, indeed, has
given us a most dangerous American fever of the remittent kind

1 12 NOSOLOGY- [CL. III.-OR. 1.

Continens putrida. Lomm.
Febris continua putrida. Boerh. Wintringh,
u. Sudatorius. Carried offbv a critical sweat in an early
stage of the disease ; an eifect often produced by ve-
nesection.
Synochus sudatoria. Sauv.
C Flavus.. With yellowness of the skin, attended with a
sense of burning heat. Nearly allied to Epanetus
flavus, and E. ardens.
Synochus ardens. Smiv.
y Puerperarum. Occurring on the third day after child-
birth ; rigor severe ; tension and great tenderness of
the abdomen.
Febris puerperalis. .iuct.
Child-bed fever. — Puerperal fever.
J Soporosus. Accompanied with great drowsiness, stupor.
« or heavy sleep almost from the beginning.

Synochus soporosa. Sauv.
Febris continua, ann. 1 373. Sijdenh.

Found also, occasionally, as a symptom in dysentery,
pleurisy, rheumatism, catarrh, and most of the exanthe-
ma tous order.

with a tertian type, which he denominates Tritaeophya Americana,
and which is usually supposed to be a variety of the epanetus ma-
lignus ; yet he takes little notice of the bilious colour of the skin^
though he admits there is an undue secretion of bile, and mentions
*•' voraitio biliosa ' as one of its symptoms.

1. Enecia^ Cauma. On the various modifications of the pulse in
fever, and especially in the species before us, the student should by
all means carefully peru*e Dr. Fordyce''s Dissertations on the subject,
and particularly the first part of his third, and the whole of his
fourth ; in both which he lays down some very obvious distinctions
between the strength of the pulse, its hardness, softness, obstruction,
and freedom. With him the grand pathognomic symptom of cauma
is hardness of the pulse. This accompanies it from first to last, in
its simplest, and in its severest state. When the disease is mild, it-
is hard alone ; when more violent, it is at the same time full, strong,
and frequent. The obstructed pulse is often confounded with the
hard, and it is not easy to distinguish them without considerable
practice. There is a rigidity of resistance to the finger in each,
but of a different kind. In the hard pulse it is much firmer and ten-
ser; and is supposed by Fordyce to result from such an Increase of
arterial contraction as to overbalance its correspondent dilation. It
indicates, in his opinion, a very high degree of living power, and is
peculiarly characterized by a tardy coagulation of the blood when

€L. Iir.-OK. II.] NOSOLOGY. 113

ORDER II.

PHLOGOTICA,

INFLAMMATIONS.

Fixed heat and pain, or soreness; increased secret ion, lesion
of a particular part or organ; mostly accompanied with fever,

drawn freely into an hemispheric hason, in consequence of which
the red particles have time to subside, and leave the surface colour-
less, or with a huffy appearance, in the obstructed pulse, on the
contrary, the blood coagulates at once ; and the red piirticles not
having time to separate, the surface is of the same hue as the cake
below. It has appeared to the present writer, that while the hard
pulse is produced by an increased action of the muscular tunic of
the arterial syr^tem, the obstructed results rather from decreased ac-
tion or elasticity of the cartilaginous tunic, over which the living
power exercises as considerable a controul as over the iormer, as
might be proved by innumerable illustrations if we had time.

The German physicians describe other moditications of the pulse,
as the pulsus celer as opposed to the pulsus frequens, and the pulsus
rarus as opposed to the pulsus tardus. But as they have not been
able very exactly to agree upon these divisions, and especially the
rival professors at Halle, Stahl and Hoffman, it is not necessary to
dwell upon them in the present note.

2. «. E. Typhis, Miiior. See Dr. Bierchens account of the Up-
sala typhus, in his paper Morbi Espeditionis Classicse. Jimccnit.
Academ. Vol. v. art. 76 ; an article well worth consulting.

3. y E. Synochus Puerperarum. This is regarded by many prac-
titioners as a mere v;>riety of peritonitis ; and has hence been at-
tacked by a powerful cvacuant and antiphlogistic plan ; especially
that of bleedings and purgatives. For the last, Dr. Armstrong has
employed calomel to the extent of twenty or thirtygrains at a dose,
assisted with sulphate of magnesia ; and on the accession of the dis-
ease, as he tells us, with success. '■'■Facts and Observ.'''' Sic. 1814. —
By other writers, this fever, being held of a typhous rather than of
an inflammatory character, has been subjected to a directly opposite
treatment ; and by Dr. Young of Edinburgh, has been afSrmed to
be contagious.

These opinions are easily reconciled, by recollecting that the
disease is of a mixt character, a variety of a genuine eynochiis ; and
that its course and symptoms, in different individuals, must vary ac-
cording to the idiosyncracy or peculiaritv of the constitution, and
1-5

114 NOSOLOGY. [CL. III.-OR. II.

GKNUS I.
APOSTEMA.

Large, suppurative inflammalion in a deep-seated organ ; pus
copious and confined.
Apostema. Hippocr. et auct. Grac.

often, according to the state or temperament of the atmosphere, as
loaded with moisture, marsh-miasm, or other contagious pabulum.
These remarks are sufficient to discriminate it from peritonitis, and
to shew that the present is its proper place. It may possibly be pro-
duced by other causes than child-birth, and seems occasionally to
have been found in males as well as in females : but the former is
the usual cause. '' After labour," observes Mr. Cruikshank, " the
cavity of the abdomen is in part debilitated, from the great change
it has undergone in passing from a state of great tension to a state of
great flaccidity ; and if the woman catches cold, or receives infec-
tion, the mischief falls on the abdomen, as the weaker part ; just as
a person liable to rheumatism, or gout, or catarrh, or diarrhoea, on
catching cold, is seized with these different complaints." Anat. of
Absorp. Vess. p. 119.

Order II. Phlogotica. From ^htym^ " incendo, ango." Linneus
for this order employs phlogisiici Irom the same root; but as the
chemists have long since laid hold o( phlogiston, and the term, though
laely disused, has a chance of being restored, the author has pre-
ferred the derivative now offered. Cullen has phlegmasice after Ga-
len and Sauvages: but as pklegmaiia, a.nd phlegmatic, from the same
source, import in common medical language very different, and al-
most opposite ideas, this term is also purposely relinquished to pre-
vent confusion.

Sauvages divides inflammations or phlogotic diseases, with him
plegmasiae, into exanthematous, membranous, and parenchymatous :
Linneus into membranous, visceral, and muscular;, referring the ex-
anthematous diseases to another class. Cullen has disapproved of
both these modes of division, as conceiving it difficult to ascertain
the seat of the affection.

The whole of the observations of Mr. John Hunter upon this sub-
ject are worthy of being deeply studied; and will not a little eluci-
date the nature of the arrangement introduced into the present me-
thod. It may be sufficient to observe, that in treating on inflamma-
tion, he divides the body into two parts : 1 , the circumscribed cavities,
organs, and cellular membrane which connects them ; and 2, the
outlets of the body, commonly called mucous membranes, as the
(lucts of the gland«, alimentary canal, &c. p. 240, 241, 254. He

GE. I.] NOSOLOGY. 115

Apostema. Sauv.
Abscessus. Cels. et auct, Lat.
Dublet. Arab.
Eiter-geschvvulst. G.

Aposteme.

distributes inflammatory affections into three kinds, adhesive, sup-
purative, and ulcerative. Adhesive inflammation belongs chiefly to
the former of the above two parts of the body, where they are deep-
ly seated ; and appears intended to take place in order to prevent
suppuration. It applies therefore peculiarly to the genus empresma^
in the present order, except in gastritis, enteritis, and cystitis ; in
all which, however, we frequently meet with striking examples of
the adhesive inflammation, or true empresma ; insomuch that the
affected organ becomes at times so closely united with some adjoin-
ing membrane or other organ, as to obtain a kind of artificial wall
or paries, and prevent the escape of its contents into another cavity,
when ulcerated through the whole thickness of its substance. See
the note on empresma, species 10. ». Suppurative inflammation be-
longs chiefly to the same division of parts, placed near the surface^
Hunter^ p. 252, and consequently applies peculiarly to the two gene-
ra of phlegmone and phyma. The ulcerative belongs chiefly to the
second order of parts, p. 254, 25b, as the mucous membranes and
outlets; and hence principally applies to the genus erythema, as it
must also be allowed to do to that of phlysis. Deep-seated suppura-
tive inflammations and abscesses cannot well be placed in either of
these genera; and have a claim to be considered by themselves;
they are hence included in the genus apostema, with which the or-
der opens.

Dr. Young, if the author understands him rightly, unites the
phlegmone and empresma into one and the same species of inflam-
mation, inflammatio phlegmonica, of which he makes them only
different varieties. Phlegmone was, indeed, used with this latitude
among the Greeks, for it imported inflammation generally ; but it
has long been hmited to suppurative, and by most writers to sub-
cutaneous as well as suppurative inflammations, or those immediate-
ly under the skin, and those too in which the suppuration is perfect,
and occupies tl-.e whole cavity. It is possible, however, that the
author may not have understood Dr. Young aright: as he aiter-
wards makes the difl'erent species of what is here called empresma,
species of inflammatory fever or oauma.

Phlegmon then, in the present method, is used to denote an in-
flamed subcutaneous tumour, perfectly suppurative ; phyma, an in-
flamed ^subcutaneous tumour, imperfectly suppurative ; ionthus, a
subcutaneous tumour or tubercle slightly inflamed, hard, and insup-
purative : and phlysis, an inflamed, but low and broad tumour, ulce-
rative, exquisitely painful and running among the tendons, of which

116 NOSOLOGY. [CL. III.-OR. Jl.

t. COMMUNE. Inflammation common to the fleshy parts; pain
obtuse; tumour spreading externally ; tender
to the touch; pus laudable; readily incarning
when opened.
Apostema abscessus. Sauv.

the paronychia or whitlow is perhaps the only known species. The
paronychia, as Galen has justly observed, has an approach to the
erythema, or erysipelatous inflammation, which immediately follows
it, but the two must not be intermixed.

Gen. 1. Apostema. 'A?r«jT«|t«« : from *s(p<«rTj)(K<, " discedo," " ab-
scedo,'' " absum," '■' deficio."' For this term the Latins employed
abscessus: yet they did not, when speaking strictly, apply either ab-
scessus or apostema to every suppurative inflammation, but only to
those that were deep-seated, and of considerable extent, chiefly in-
deed to collections of pus consequent upon fevers, or some pre-
vious disorder of particular parts, especially abdominal diseases.
This limitation is accurately drawn by Celsus immediately after his
description of struma, furuncle, and phyma. " Sed cum omnes hi
nihil nisi minuti abscessus sint, generale nomen trahit latins vitium
ad stippurationem spectans Idque fere fit aut post febres, aut post
dolores partis alicujus, maximeque eos, qui ventrem infestarunt."
Lib. V. cap. xxviii. § H. The term abscess, however, which was
colloquially used in a loose sense in the time of Celsus, is used so
much more loosely in our own day, that it is impossible to recall it
to ifs precise and original meaning. Yet apostema has not hitherto
been thus generalized: and it is here, therefore, laid hold of, and
restrained to the signification given it above: in doing which the
author is supported by the authority of Sauvages, who has employ-
ed it with the same limitation.

4. Apostema Empyema. Ef/,wtiuet: from iu,, or «, "in or intra,"
and 5ru«», " pus." i'he term is common to ail the Greek writers,
and the persons suffering were denominated t/^TFvei, "cmpyi."" Cul-
Icn regards em[)yema as a mere sequel of pneumonia, which, with
him, includes both pneumonitis and pleurilis; but as it may take
place from inflammation of the mediastinum, pericardium, or dia-
phragm, to say nothing of that from external injuries; and as it is
often doubtiul what particular organ is directly injured, a separate
species seems decidedly called for.

In some cases, indeed, there is no organ to which the pus can he
referred as a product of ulceration : and hence Mr. Hewson con-
ceived that it is occasionally ibrmed out of the coagulable lymph,
altered in its properties b}'^ passing through inllimed vessels. " i he
cavities of the pioura, pericardium, &.C." says he, " are sometimes
observed to contain considerable (juantities of pus without the least
marks of ulceration, instances of which I h;ive seen. In one pa-
tient I found three pints of pure pus in the pericardium, without

.1.1 irOSOLOGY. 117

GE

2. psoATicuM. Pain and tension about the loins, shooting down

the spine and thigh : ditiiculty of standing
erect ; fluctuating enlargement along the psoas
muscle ; apex of the tumour immediately be-
low the groin.

Psoas. Auct. Far.

Abscessus lumborura. Auct. Alior.

Psoas abscess.

Often confounded with scrophulous abscess of the

hip-joint.

3. HEPATicuM. Diffuse, pulsating tumour in the region of the

liver; preceded b}'^ pain, a yellow counte-
nance, and shiverings.
Hepatalgia apostematosa. Sauv.

any ulcer either on that membrane or on the heart. In another, the
cavity of the pleura of the rijfht side was distended with a pus that
smelt more Hke whey than a putrid fluid, and the lungs were com-
pressed into a very small compass : but there was no appearance of
ulcer or erosion, either on these organs or on the pleura ; but only
under the pus was a thin crust of coajiulable lymph. In such cases
it is manifest the pus must have been formed from the fluids: and
as the exhalent vessels at one time appear to secrete a mere water,
at another time a coagulable lymph, and in a third (when a little in-
flamed) they secrete that lymph so viscid, and change its properties
so much as to make it coagulate instantly on being secreted ; so in like
manner they may sometimes, when more inflamed, have the power
of converting the lymph into pus." Lymphat. Syst. Part ii. p. 117.

Darwin relates a singular case of empyema, in which the pus
seems in like manner to have been produced without ulceration,
though he ascribes it indirectly to an abscess in the lungs. '' A
servant man, after a violent peri{)neumony, was seized with symp-
toms of empyema, and it was determined, after some time, to per-
form the operation. This was explained to him, and the usual
means were employed by his friend? to encourage him, " by ad-
vising him not to be afraid." By which good advice he conceived
so much fear that he ran away early next morning, and returned in
about a week quite well. Diseas. of Sens. II i. 6 4.

3. Jlpostema Vomica. From vomo, '■' to eject,'' especially from
the stomach, but not always so. The term is here used in the large
sense in which it is employed by Celsus, who applies it to a bursting
of pus from the liver, or any other large internal organ, as well as
from the lungs. "■ Si vero jecur vomica Inborat, eadem facienda
surii, qusB in caeleris interiori!<us suppurationibus." Lib. iv. cap. viii.
S.iiiv,(ges follows him in this interpretaiion. Boerhaavc and Cuiien
conhne vomica to the lungs, and that in a more restrained sense

118 NOSOLOGY. [CL. III.-OR. II.

Abscess of the liver.
4. Empyema. Fixed pain in the chest ; breathing laborious ;
easiest in an erect position ; difficult decumbi-
ture on the sound side; fluctuating enlarge-
ment on the side aifected ; dry, tickling cough.
Empyema. Auct. Grose, ef neoteric.
Lodgment of matter in the chest.

Goekel describes a case in which the pericardium
and the right lung were totally consumed.
Gallicinium Medico-Pract.
-r). Vomica. Deranged function of a thoracic or abdominal or-
gan, succeeded by copious discharge of pus
into some part of the alimentary channel, and
its evacuation by the mouth or anus.
Vomica. Cels.
Apostema vomica. Sauv.

GENUS II.
PHLEGMONE.

Suppurative, subcutaneous tumour; tensive; glabrous;
painful ; at length fluctuating, and bursting spontane-
ously; the pus uniform and mature.

than most writers; for they limit it to what has been called, though
with no great accuracy, occult vomicae {yomicoi claime.) Linneus
and Vogel, on the contrary, while they confine the term to the
lungs, explain it by open vomica), {vomicce apert(c^) in which the pus
is thrown forth profusely and suddenly.

Gi:n. II. Phi,egmone. 0A.yf«o»»j from ^Xtyu, " inflammo :" " in-
flanunationem qiiam Grajci (pMyiu.»yiiiv nominant. ' Cels. lib. i. The
term among the Greeks was used for infl mimation generally : it
has long since been employed in a far more limited sense by modi
cal writers of perhaps every school; and its immediate meaning
in the present work has already been explained in the note on
Pur.ocoTii A, the term for the order before us.

4. Phleginone parotidea. It is not a little singular that Dr. Cullen,
who extends phlegmone wide enough to embrace not only inflan)-
mation of the ear and of the breast, gum-boil, and phimosis, but al-
so furunculus, varus, gutla rosea, hordeolum, and even various ni-
fections of the bones, should have banished suppurative inflamma-

GE. II.] NOSOLOGY. 119

Phlegmone. Sauv. Vog.
Phlogosis phlegmone. Cull.
Inflammatio. Sag.
Geschwar. Germ.
• Zameh. Arab.
Phlegmon.
1. COMMUNIS. Tumour common to the surface: bright-red;
hard ; defined ; hemispherical ; polarized ;
gradually softening and bursting at the pole.
Eiter-beule. G.
Clou. F.
Push.
1. PARULis. Tumour seated on the gums ; deep-red ; hardish ;
undefined ; pain obtuse.
Parulis. Sennert. Vogel.
Apostema parulis. Sauv.
Gum-hod.

tt Simplex. Limited to the substance of the gums.
C Cariosa. Connected with a caries of a tooth or socket.
3. AURis. Tumour seated within the ear 5 pain acute, throb-
bing ; heat and redness spreading externally;
hearing distressingly keen, or stunned with imagi-
nary sounds ; abscess bui'sting with the sense of a
loud snap or explosion.

tion of the parotid and inguinary glands not only to another genus,
but to a very remote part of his system, where they occur in the
class and order of local tumours, in company with warls, corns, and
sarcomata, which have no inflammatory character. Here too they
are conjointly described under the generic name of bubo, with the
generic character of " giandulse conglobatae tumor suppurans;" a
definition which does not apply to the parotid gland, whose struc-
ture is not conglobate, but conglomerate. The present appears to
be the proper place for suppurative inflammation of the parotid,
and inguinal as well as of the mammary glands.

5. Phlegmone mainmce^ called by Dioscorides sparganosis, from
vTrxpyxat, *•' tumeo," " distendo." This term, however, he employ-
ed collectively to signify milk-abscess, and a variety of tumours,. in-
tumescences, and other diseases, supposed to depend upon an over-
flow, suppression, misdirection, or depraved secretion of milk; and
especially those which have been since described under the general
term galactirrhcea : many of these however have little or no rela-
tion to each other; and particularly abscess of the breast, and the
swelling of the lower limb, which occ.isionnlly takes place soon af-
ter child-birth, to which last the term is restrained in the present
system.

120 NOSOLOGY. [CL. III.-OR. H.

Inflammatio aurium. Sennert,
Otalgia inflammatoria. Sauv*
Imposthume in the head.

Often a result of suddenly suppressed morbid discharges:
sometimes a symptom of worms.

4. PAROTiDEA. Tumour seated under the ear : reddish; hard;

pain obtuse ; suppuration slow and difficult.
Parotis. Gal. Sauv. Vog. Sag.

« Benigna. Incarnation, and cicatrization regular and
unobstructed.
Parotis benigna. Sauv.
6 Maligna. Pus illaudabie, profuse, protracted ; succeed-
ed by foul sloughs.
Parotis maligna. Parr. See Appendix to his Diet. art.

Parotis.
Usually appearing in advanced life, or about cessation
of (he catamenia.

5. MAMMAE. Tumour seated in the breast ; pale-red ; hardish ;

in irregular clusters ; pain pricking and acute ;
suppuration quick and copious.
Abscessus mammarum. Roder a Castro.
Mdstodynia apostematosa. Sauv.
Phlegmone mastodynia. Cull.
Jema. Mrab.
.Abscess of the breast.

a Violens. From severe pressure or blow.
C Lactantium. F'rom redundancy of milk.

Mastodynia polygala. Sauv.

Depot laiteux aux mammelles. Pazos.

Milk abscess.

" In these cases the suppuration commonl}' begins in many distinct
portions of the inflamed part ; so that it is not one large circum-
scribed abscess, but many separate sinuses, all of which generally
communicate. Now it usually happens that only one of these points
externally, which being cither opened or allowed to break, the
whole of the matter is to be discharged this way. Put it some-
times happens that the matter does not find a ready outlet by this
opening and then one or more of these ditTerent sinuses make dis-
tinct openings for themselves." Hunter on Blood, p. 469.

6. Phlegmone Bubo Usually derived from ZovZui^ (boubon) in-
guen^ and hence importing a tumour not unfrequently found in this
organ. It is probable, however, that the proper root of both the
Greek and Latin terms is the Hebrew Viyi- Aofco, " a purulent tu-
mour;'' by the iyeptuagint rendered (pXiKTu, (phlyctis) : which was

GE. II.] NOSOLOGY. 121

6. BUBO. Tumour seated in a conglobate gland; reddish;

hard ; diffuse ; not easily suppurating ; opening
with a callous edge.
Bubo. Sauv. Linn. Cull.
Phygethlon. Vog.

Denbel. Arab. The origin is Persian.
Schlieren. G.
Bubon. F.
a, Simplex. Unconnected with any constitutional or

foreign poison.
S Virulentus. Produced by a specilic virus, or connect-
ed with constitutional affection.
Tippel-beul. G.
Khyarjek. Arab.

The glands mostly infected are those of the inguen
and axilla. The last variety found chiefly in lues and
pestis. Often cured by vomits after suppuration has ad-
vanced. Hunter on Blood, p. 388.

7. PHiMOTiCA. Tumour seated in the prepuce ; diffuse ; obtuse-

ly painful ; imprisoning the glans, or strang-
ling it by retraction.
X Tncarcerans. The prepuce protracted, and imprisoning
the glans.
Phimosis. Heister, Chirurg. cap. cxxx.
Phimosis vera. Sauv.
C Strangulans. The prepuce retracted and strangling the
glans.
Phimosis circumligata. Sauv.

the common term among the Greek writers for fluid tumours of
every kind, whether ichorous or purulent; and hence Tiy^y^K,
Exod. ix. is rendered in the Alexandrian version, (pA/xT<§sj, and m our
own translation hlains. V^iyil, (hobo,) is the mere reduplicate or
argument of yi, (bo)^ or HV^, (boa,) (for the H is omissible,) and
imports " to swell or bubble," as water over the fire; and hence
y;2yi, (bobo,) is a large swelling, whether a bleb or bubble, or
more solid tumour, as a bubo, or boil.*

Gen. 111. Phyma. 'Jfvjxx. " tuberculum," from (pvai, " produco,""
" erumpo."' It was used among the Greeks with great latitude, and
hence with an apparent want of precision : sometimes in the mo-
dern sense of phlegmon, for tumours larger than a furuncle or boil,
but less painful and inflammatorj', and perfectly suppurative, with-
out any core or ventricle. So Celsus, lib. v. cap. xxviii. sect. 9 :

* Qu.? Bile : see Johnson, Sec.
16

122 NOSOLOGY. [CL. III.-OR. II.

Paraphimosis. Auct. Grac.
Circumligatura. Auct. Lat,

Found frequently as a symptom in lues and ble-
norrhoea.

GENUS III.
PHYMA.

Imperfectly suppurative, cutaneous, or subcutaneous tu-
mour ; the abscess thickened, and indurated at the
edge ; often with a core in the middle.
Phyma< Willan» Sauv. Sag.
Eiter-blasen. G.
2, Hordeolum, Tumour seated in the verge of the eyelid j
granular ; hard ; reddish ; sore to the touch ;
suppuration confined to the point.
Crithe («g<d».) Auct. Grac. Vog.
Hordeolum. Auct. Lat. Plenck et Alior.
Zefer. Arab.
Gerstenkorn. G.
Orgeolet. F.

*'• ^vfMc, nominatur tuberculum furunculo simile, sed rotandius et pie-
nius, saepe etiam majus : — sed inflammatio, dolorque sub eo minores
sunt. Ubi divisum est ; pus eodem modoapparet; ventriculus, qui
in furunculo, non invenitur: varum omnis corrupta caro in pus ver-
titur." To the same effect, Galen De Arte Curat, lib. ii. who tells
us that the swelling and suppuration procceed rapidly-; " statira au-
getur, atque ad suppurationem festinat." Hippocrates, on the con-
trary, applies the term to tubercles imperfectly suppurative, and in
his Praedict. lib. ii. sect. 2, as well as in various other places, speaks
of scrophulous phymata, ^vfuiTx x,oi^uhw, and his example is fol-
lowed by Paul of ^Eg-ina, lib. lii. It. Even Celsus, lib. vi. cap. 18,
affirms, that the Greeks called also by the name of phymata, a ge-
nus of tubercles that are accustomed to spring up about the glans
penis, which they cauterised, and afterwards treated with a;rugo
seris, to prevent their sprouting again ; and which appear therefore
to have been regarded as of the nature of warts, or excrescences :
while the general body of the Galenists, as Sauvages observes, ap-
plied the term to protuberances of every kind. Tom. i. p. 137.

Modern writers have hence been at a loss in what sense phyma
•bould be used, Linneus and Cullen have rejected it. Sauvages

GE. III.] NOSOLOGY. 123

Stye,

Often produced by the state of the stomach. Plenck
afTirms that he knew a man who uniformly had a stye af-
ter drinking ardent spirit. He points out the following
• resemblance between a stye and a boil — " est luberculum
inflammatorium, /)arx)o fiirunculo simile, in margine palpe-
brarum."
3. FURUNCULUS. Tumour common to the surface; deep-red:
hard ; circumscribed ; acutely tender to
the touch ; suppurating with a central core.
Furunculus. Sauv. Linn. Fog. Sag.
Demmel. Arab. Of Persian origin.
Harte-beule. G.
Furoncle. F.
Boil.
A, SYCOSIS. Tumour excrescent; fleshy; fig-shaped; darkish
red ; sprouting from the hairy part of the head
or face : gregarious ; often coalescing ; dis-
charge partial and sanious.
Sycosis. Cds. Vog. Bateman.

tt Barbae. Tumour hard, roundish, pea-sized ; seated in
the beard; commonly in clusters; occasionally
confluent, and spreading from ear to ear; discharge
small and glutinous ; beard matted.
Sycosis barbae. Cds.
Mentagra. Plenck.
Kieferaussatz. G.
Sycosis menti. Bateman.
C Capilli. Tumour soft, unequal, clustering : seated in
and about the hair of the head : discharge ichorous,
copious, and fetid, from a fungous surface.

and Sagar have employed it as the name of a distinct and separate
order. Vogel, following the example of Hippocrates and Paulus,
has reduced it to a genus of imperfectly suppurative and glandular
tumours: and as a genus it occurs in Dr. VVillan's table of arrange-
ment, including boils, carbuncles, and similar inflammations as its
species. This seems to be the most accurate sense, and as such is
adopted in the present system. The resemblance between the boil
and the carbuncle is pointed out by Mr. John Hunter in his Treatise
on Bloody p. 273.

4. Phyma Sycosis. Sux«o-«j, from vvkov., " ficus." The Greeks
gave this name to various tubercles and excrescenses, the shape of
which was conceived to resemble that of a fig. By Celsus, how-
ever, De Med. p. vi. cap. iii. it is limited to a particular kind of in-
flammatory and imperfectly suppurative tubercle of the head and
face : Vogel has understood the term nearly in the same sense : and

124 NOSOLOGY, [CL. III.-OR. 11.

Sycosis capilli. Ccls.
Sycosis capillitii. Bafeman,
5, ANTHRAX. Tumour common to the surface; flat; firm;
burning; penetrant; livid and vesicular; or
crusty above, Avith a sordid and gangrenous
core below ; imperfectly suppurative.
Anthrax. Auct. Gnec. Sauv. Linn. Sag.
Erythema, anthrax. CulL
Carbunculus. And. Lot.
Jemmera ; Jlrab. but by Avicenna occasionally Nar

Faci, Ignis Persicus.
Carfunckle. G.
Charbon. F.
Carbuncle.
a Pruna. Escar- carbuncle. Crust black ; oozing an ero-
sive ichor, or sanies.
Pruna Avicenn. So denominated from its assuming the
colour and often the oval figure of the sloe, or fruit of
the prunus spinosa, Linn.
> Terminthus. Berry, or Fungus-carbuncle, Core or
fungus spreaking in the shape, and assuming the
figure and blackish-green colour, of the fruit or berry
of the pine-nut, or rs^fimdes, the pinus abies, Linn,
called by the Latins terebinthus; whence terebinthus
and terminthus have been employed as convertible
terms in describing the present disease.

Dr. Bateman has hence correctly introduced it into his list. The
second variety, as the last writer observes, makes an approach to
one or two species of porrigo, but it has characters sufficiently
marked to keep it distinct.

5. Plujma., Anthrax. 'Av5pas|. Gal. Paul. JEgin. " carbo." " The
inflammation that produces the carbuncle is of a difierent nature
from any of the former : it is stationary with respect to place, and
k pretty much circumscribed, even forming a broad, flat, firm tu-
mour. It begins in the skin almost like a pimple, and goes deeper
and deeper, spreading with a broad base under the skin in the cel-
lular membrane. — It produces a suppuration, but not an abscess,
somewhat similar to the erysipelatous when the inflammation passes
into the cellular membrane : for as there are no adhesions, the mat-
ter lies in the cells where it was formed, almost like water in an
anasarca. — This inflammation attacks more beyond the middle age
than at it, and very few under it. It is most common in those that
have lived well : 1 never saw but one patient of this kind in a hos-
pital. It appears to have some affinity to the boil ; but the boil dif-
fers in this respect, that it has more of the true inflammation, there-
fore spreads less, and is more peculiar to the young than the old,

GE. III.] NOSOLOGY. 125

This variety bears a considerable similitude to the
epian of South America, and the yau of Guinea ;
terms which signify in their respective countries
raap or straw-berry, from the resemblance of the fun-
gus to diese fruits, and which have hence been trans-
lated/ramfecesia by the Latin writers of France.

GENUS IV.
lONTHUS.

Unsuppurative, tubercular tumour : stationary; chiefly com-
mon to the face,
lonthus. ('io»9<)5.) Aucl. Gr(ec.
Varus. Auct. Laf.
Finnen. G.
J. VARUS. Red; hard; pimply; distinct; gregarious; sore to
the touch ; sometimes oozing a little fluid at the tip.
Varus- L'mn. Vog, Sag.
Acna. Aetii.
Psydracia Acne. Sauv.
Acne. Bateman.
Rothpfinnen. G.
Bougeons. F.
Stone-pock.
«. Simplex. Broad-based, bright-red, solid.

Acne indurata. Bateman.
? Punctatus. Tipped with a black dot, discharging, on
the pressure of the finger, a grub-like concretion of
mucus.

which may be the reason why it partakes more of the true inflam-
mation." Hunter on Blood, p. p. 272, 273.

This species, like paronychia, has an approach to the character
of erythema, and is ranked under it by Dr. Cullen Yet a little at-
tention will, perhaps show, that it belongs rather to the genus under
which it is here placed : it is " a phlogotic or inflammatory tumour
on the surface, imperfectly suppurative," firm, stationary, circum-
scribed, with a gangrenous core or eschar.

Gen. IV. loNTHus. 'UtSoi, literally •' violet or purple eruption,
or efflorescence," from <a», " viola ;" though the etymologists differ
in deriving the term ; some referring us to etiSc?, " flos," from whence

126 NOSOLOGY. [cL. IlI.-OR. II.

Punctge mucosae. Darw.

Acne punctata. Bateman.

Maggot-pimple.
2. CORYMBIFER. Confluent ; corymbose; rosy; mottled . with
purple ; often disfiguring the nostrils with
pendulous lobes ; irritated by cordials or
exposure to heat.
Gutta Rosea. Sanv. Dariv.
Acne rosacea. Bateman.
Bacchia. Linn.
Roth-gesicht. Roth-nase. G.
Couperose: Rougeurs. Goutte-rose. F.
Carhnncled-facc,
Rosy-drop. Welk.

Shakspeare has alluded to the whole of these in the
following passage, as also in many others : —

'^ His iVire is all bubukles, and whelks, and knobs, and
flames of fire."

The first is found also occasionally as a symptom in
diseases of the stomach; and both in diseases of the liver,
chiefly from an habitual indulgence in spirituous potation.

GENUS V.

PHLYSIS.

Ulcerative, subcutaneous tumour: flat; tensive; glabrous i
diffused ; hot ; throbbing ; al length fluctuating with
an acrid ichoi-.
1. PARONYCHIA. Seated about the nails and ends of the fingers :

we have exanthem ; and others to 8>««j, " fimus," " inquinatio,''
"foulness," "defilement." f'ollux, lib. iv. expressly tells us, that
the Greek ionthus is synonymous with the Latin varus ; and Diosco-
rides,.lib. i. cap. 40, has »mitod it with morphew, freckles, and other
blemishes of the face, ivy»f*.i» 5' 6;^« »x6»fTiitv» vTriXuVf <pu»m, ie>tf«»,

Gkn. V. Phlysis. <I>Av9-<?. Hippocr. from (pxva, ®A«^a», " ferveo,
bullio." The term, wuh all its compounds, was used in a general
and indeterminate sense by the Greeks to express cutaneous erup-
tions, filled with a fluid of any kind, whether purulent or ichorous;
and hence (pXv*Tximi, (|)hlyctainaj) from the same, imported, as there
will be occasion to show farther hereafter, both pustules and vesi-

GE. v.] NOSOLOGY. 127

pain acute and pricking ; shooting up the
hand.
Paronychia. Auct.
Dahus. Jlrab,
Nagel-geschwar. G.
Panaris. F.
Wliitlozo,
» Cutanea. The acrid eftusion seated between the skin

and parts immediately subjacent. Heist. B. Bell.
C Tendinis. Effusion seated between the tendons and the

periosteum. Heist. B. Bell. Garangeot.
y Periostii. The eftusion seated between the periosteum
and the bone, which is often rendered carious.
Heist. Wisem. B. Bell.
Malignant Whitlow.
Felon. "The malignant paronychia is that which is

commonly called a felon." Wisem.
Similar inflammations are occasionally to be found in
the soles of the feet and palms of the hands: they break

cles, as the terms are contradistinguished in the present day. More
generally, however, the phlysis and its ramifications bad a bearing
towards the sense of ichorous or vesicular swelling; and hence Dr.
Willan has correctly restrained phlyctaenae to this meaning in his
definitions. Phlysis, in the present work is equally restrained, as
are also its compounds emphlysis and ecpblysis, formed after the
manner of empbyraa and ecphyraa from phyma ; and of erapyesis
and ecpyesis from pyesis. Among the Auglo-saxoo historians, as
Bade and Malmsbury, pustules are called poccas; vesicular erup-
tions, blegen (blains ;) and boils, or eruptions with an imperfect sup-
puration, blacain blegene

For the peculiar nature of Ibis kind of inflammation, and its mode
of treatment, see Hunter on Blood, p. 4f.>9.

Gev. VI. Erythema. E^v6»i/ii», from tfiv$t{^ ''rubor." This is
undoubtedly a term of Hippocrates : it occurs not only in bis Prce-
notiones Coacce^ the genuineness of which is disputed, but in the ad-
mitted books of his Epidemics; and is translated by Duretus suffusio
erysipelatrsce ; and hy Galen and Celsus erysipelas. In this sense
erysipelas has descended to our own day in its popular use ; while the
nosologists, with a few exceptions, have limited it to a peculiar spe-
cies of exanthem or eruptive fever, and have revived the Hippo-
cratic term erythema, to import a peculiar species of local inflam-
mation, in which the febrile iff°ction is merely symptomatic. The
first three species here ofi'ored are taken from Mr. J. Hunter, and
are too distinctly marked, and of too much importance, to be omit-
ted.

.128

xNOSOLOGY. [CL. Ill.-OR. II.

through the cuticle with difficuUy from its thickness, and
hence become diffused, and separate the cuticle from the
skin beneath. The bite or poison of the gordius aquati-
cus, or hair-worm, is said to have a peculiar tendency to
produce this affection.

GENUS VI.
ERYTHEMA.

Red, glabrous, tumid, fulness of the integuments ; disappear-
ing on pressure; pain burning; inflammation ulcerative;
terminating in cuticular scales or vesicles; occasionally
in gangrene.

Erythema. Hippocr. et Aut. Var.

Hieropyr. Vog.

Hautrothe. G.

Erysepele. F. but improperly so called.

Inflammatory Blush : improperly called Erysipelas,

1. (EDEMATosuM. ColouT scarlet ; spreading widely and deeply

through the cellular membrane, which
often imperfectly suppurates, sloughs, and
becomes gangrenous.
Edematous Injlammation. J. Hunter on Blood, ch. ii.
p. 269.

2. ERYSiPELATosuM. Colour decpish-rcd ; superficial ; with a

determined edge ; migrating in a ser-
if these characteristics be kept in view, it will not be difficult
to draw the line between what should constitute erythema and what
erysipelas. The first bears the same analogy to phlegmon as the last
does to small-pox. Phlegmon is local inflammation, tending to sup-
puration ; erythema local inflammation, tending to vesication : small-
pox is an idiopathic fever producing a phh^gmoiious efflorescence;
erysipelas an idiopathic fever producing erythematic efflorescence.
Small-pox is always contagious; erysipelas occasionally so: phleg-
mon and erythema have no such tendency.

It must, nevertheless, i)e recollected by the learner, that erysipe-
las has been applied sometimes, even by good writers, to erythema,
as well as to the exanthcm i)roperly so called, for otherwise the two
diseases will be perpetually confounded. Thus the first three spe-
cies of erythema here noticed are only to be found under the term
erysipelas in J)r. Willan's arrangement, which is made to embrace

GE. VI.] NOSOLOGY. 129

pentine direction ; the part which has
passed through the action heaHnj^, as the
part next attacked becomes aft'ected.
Erysipelatous Inflammation. J. Hunter on Blood, ch. ii.
p. 269.

3. GANGRENOSUM. ColouF duskj-red ; superficial; cuticle se-

pai*ated from the cutis by a bloody serum ;
the cutis, when denuded, exhibiting dark-
brown spots, disposed to blister and
slough ; occurring chiefly in the extremi-
ties.
Ignis sacer. spec. 2. Cels.

Gangrenous Injiammation, J. Hunter on Blood, ch. ii.
p. 274.
• All these species are usually to be found in debilitat-

ed or relaxed constitutions : the former too often ap-
pear as sequels of atonic fevers ; the third is common to
old age, and early infancy. See Underzvood on the Dis-
eases of Children ; as also Willan on Erysipelas errati-
cum.

4. vESicuLARE. Colour pale-red 5 surface roughish, and cover-

ed with crowding minute vesicles, filled wi'h
an acrid, often a reddish, fluid ; progres-
sively trailing into the neighbouring sound
parts.

both erythema and erysipelas, as the terms have hitherto been com-
monly employed ; while erythema is arbitrarily made use of to cha-
racterize another collection of cutaneous ernbescences of very diffe-
rent characters, and produced by very different causes ; some of
them primary, others symptomatic, affections; some constitutional,
others local : occasionally smooth, papulous, tubercular, or nodose :
but all which seem to belong to different divisions.

4. EryetJiema^ vesiculare. This is intended to delineate the ignis
sacer of the ancients, which has been seldom understood, and never
hitherto allotted a clear methodic position. The common error has
been in making it an exanthem or eruptive fever, an erysipelas or a
pestis, or a distinct disease approaching to the one or the other.
There is no doubt that it has at times been an accompanying symp-
tom in pestis, and has consequently produced a variety in this fever
which the reader will find noticed under the head pestis by the dis-
tinguishing term erythematica, of which nature was the plague of
Athens, so excellently described by Thucydides and Lucretius. But
the ignis sacer, in its genuine and simple state, instead of t>emg a
typhous eruptive fever, has often very little fever of any kind, never
17

130 NOSOLOGY. [CL. IIl.-OR. II.

Ignis sacer. Cels. spec. 1.
« Benignum. The redness and vesicles advancing with-
out a breach of the cuticle, as the part that has pass-
ed through the action is healing.
Ignis sacer. Cels, spec. 1 . var. ».
C Corrosivum. The vesicles breaking in the part first
affected, and the erosive fluid producing tracks of sa-
nious ulceration as the redness advances.
Ignis sacer. Thucyd. Lucret. vi. 1165. Cc/s. spec. 1.

var. £.
Feuerflecke. G.
Macula lata Plateri. Plenck.

It is to this the Turkish physicians give the name of
Tatlu ujuz, literally dulcis scabies.

The eczema rubrum of Dr. Bateman, but which, as
he candidly acknowledges, is incongruous with his ge-
neric character of eczema, seems fairly to belong to this
species ; and, if not one of the above, may form a third
variety. — It is correctly denominated an erythema by
Dr. Marcet, Medico-Chir. Trans. II. ix. and by Dr. Rut-
ter. Edin. Med. and Surg, Journ. IV. p. 143.

Found also, occasionally, as a symptom in pestis, and
as a sequel on the exhibition of mercury in irritable
habits; and hence denominated by some authors ery-
thema mercuriale and hydrargyria,

perhaps more than symptomatic fever; and by Celsus is described
as being best cured by an ephemeral or other fever that may give
increased action to the system ; hereby proving this, as well its every
other variety of erythema, to be a result of debility.

The character and subdivisions of ignis sacer^ as offered in the text
under the heads e. gangreenosum, and e. vesiculare, are taken from
Celsus, and given, as nearly as may be, in his own words, to prevent
all doubt. He describes it as a genus comprising two species, of
which the former has two varieties. " Duae species sunt. Alterum
est siibrubicunduin, ant mistwm rubore atque pallore^ exasperatumqne per
pustulas {^XvnTctitcts) continuas, quarum nulla altera major est, sed
plurimae perexiguce. In his semy>er fere pus, et saepe rubor cum ca-
tore est." Then follow the two varieties as described in the text
above: «e '■'' Serpiique id nonnunqnam, sanescente eo, quod primum
vitiatum est : S nonminquam etiam exulceratio, ubi rtiptis pustidis
(^AvKTceira*?) ulcus continuatur, humorque ecu.'"

He then passes on to describe the second species, which answers
to the character and almost to the words of erythema gangrainosum
in the text. " A'K 'Miru, aulem, in sumnKr cutis PTulceratione, sed
xine altitudine^ latum, subltvidum, inaequniiter tamen; mediumque

GE. Vt] NOSOLOGY. 131

S, PERNIO. Colour crimson suffused with blue; obstinately
itching; chiefly affecting the extrenaities during
winter.

Erythema pernio. Sauv,

Pernio. Linn. Vog.

Erythema a frigore. CulL

Kalte-geschvvulst. G.

Engelure. F.

Chilblain.

a. Simplex. The cuticle remaining unbroken.

sanescil, extremis procedentibus ; ac saepe id, quod jam sanum vide-
batur, iterum exulceratur : at circa, proxima cutis, quae vitium re-
ceptura est, tumidior et durior est, coloremque habet ex rubro sub-
nigrum. Atque hoc quoque malo — in cruribus maxime.'''' Lib. V.
cap. xxviii. sect. 4.

The author has ventured to translate the puslulce of Celsus in the
present instance ^At;)BT««K»<, vesicles^ first because he thus explains
the term in sect. 15 ot the saine chapter; and secondly, because in
the ignis sacer, which, as we learn both from Thucjdides and Lu-
cretius, was a symptom in the plague of Athens, the former has
given us this precise term. The following couplet is sufficient from
Lucretius De Rer. Nat. vi 1164.

Et simul, ulceribus quasi inustis, omne rubere
Corpus, ut est, per membra sacer quum diditur ignis.

Wide ting'd with purple dye, and brandish'd o'er
With trails of caustic ulcers, like the blaze
Strew'd by the holy fire.

In Thucydides the same symptoms are described thus :

v7ri^')6^o»i TtiXi^voVf *ATKTAIN.hIS MIKF ISy xeti iXxtcriv t^n*h»»i.

"• Yet the body outwardly was not very hot to the touch, nop
pale but deep-red, livid, and efflorescing with minute vesicles^ and
ulcers."

In Seneca, who has closely copied from Lucretius, the phrase sacer
ignis is still preserved. Q^dip. 187.

Oculique rigent, et sacer ignis
Pascitur artus.

Stiff stare the eye-balls ; for the burning limbs
Deep feeds the holy fire.

5. € E. Pernio, Exulceratus. In very cold latitudes it often aflFects
the nose ; and the living power is destroyed as completely as by
combustion. See BibUoth. Med. Manget, iii. p. 492, Winkler de

132 NOSOLOGY. [CL. III.-OR. If.

C Exulceratus. Accompanied with ulceration.
Kibe.
6. INTERTRIGO. Colour bright red; cuticle eroded; the ex-
posed cutis oozing a limpid and acrimoni-
ous fluid.
Erythema intertrigo. Sauv,
Intertrigo. Linn. Vog.
Erythema ab acri inquilino. Cull.
Kerch. Arab.
Frat. G.
Ecorchure. F.
Fret. Erosion of the skin.

From peculiar acrimony in the matter of perspira-
tion ; or acrid substances intermixing with its natural
secretion; especially in folds or dimples of the skin;
most frequently in the groins and behind the ears of
infants, whose cuticle is extremely delicate, and easily
eroded. See Rhazes ad Almans. Tr. vi. cap. 17, 18.

GENUS VIT.

EMPRESMA.

Deranged function of a visceral organ, membraneous or pa-
renchjmatous ; with local pain; fever mostly a cauma ;
inflatumaUon mostly adhesive.

PhlegiuaLias membranosae et parenchymatosae. Sauv.

Sag.
Phlogistici. Linn.

Frigore, 4 Leip. 2. 1137. Belgrado Del Galore e del Freddo. Farm.

So. Milton, Par. Lost, ii. 294.

the parching air

Bums f'rore ; and cold performs th' eflfect of fire.
Perhaps from Virgil, Georg. 1. 93.

Boreae peuetTahilk frigus adurat.

Gkn. VII. Empresma. Presma (jr^Dcr^a,) from jrgjjtfoi, "inflammo,"
is in use both b)' Hippocrate-* and Gaien, to express inflammation
generally. Empresma, from ift7r^Yi6a, '' intus flammo, incendo," ip
Jiere employed to signify internal or visceral inflammation.

GE. VII.] NOSOLOGY. J 33

Febres continuas inflammatorias. Fog.
Inflammatio interna. Macbr.
Cauma. Youngs

1. CEPHALITIS. Acute pain in the head; intolerance of light

and sound; face flushed ; eyes red; cau-
ma ; watchfulness ; and delirium.

Siriasis (sri^iutrti.) Hippocr. Vogel.

Sideratio. Auct. Lat.

Phrenitis. Sauv. Sag. Hoffm. Boerh. Cull. Macbr.

Sphacelismus. Etmull. Linn,

Cephalitis. Sauv. Sag.

Inflammatio phrenitis. Parr.

Cauma phrenitis. Young.

Sersam. Of Persian origin.

Junun. Arab.

Hirn-fieber. Hirn-wuth. G.

Phrenesie. Inflammation du cerveau. F.

Pkrensy. Brain fever.

Found also, as an occasional symptom, in synochus,

worms, various exanthems, trichoma, hydrophobia, in-
juries of the cerebrum, and severe grief.

2. OTITIS. Severe pain in the ear; tenderness upon pressure;

deafness or confusion of sounds.
Otitis. Vog. Young.
Ot dgia. Sauv. Linn. Vog.
Dolor otalgicus. Hoffm.
Ohr-schmertz. G.
Douleur d'oreille. F.
Ear-ache.

1. Empresma Cephalitis. This word is preferred to phrenitis, as
more descriptive of the organ afi'ected. Dr. Cullen has correctly
observed, that we are not acquainted with any pathognomic symp-
toms by which to distinguish inflammation of the brain from that of
its membranes; and he has hence reduced the cephalitis, phrenitis,
and sphacelismus of preceding writers, to one genus. The present
system follows him in this instance of generalization. According to
Dr. Clutlerbuck's hypothesis, all fevers are mere varieties of this
species. Inquiry, kc. Sect. viii. p 138.

Sauvages, Vol. i. p. 458, asserts that the name among the Arabic
writers for this disease is sirsen. We have here a double mistake :
sirsen should be sersam, and the word thus used is Persian, and not
Arabic. It is, however, extensively copied in the east, and has
found its way into the Turkish dialect. See the lexicon entitled
Laghati Halimi.

134 3^OS0L0«Y. [cL. ni.-OR. II.

3, PAROTITIS. Painful, unsuppur;uive tumour of the parotid

glands, often extending lo the ma;illriry;

conspicuous externally; often accoaipanied

with swelling of the testes in males, and of

the mammaQ in females.
Cynanche parotidaea. Sauv. Cull. Parr.
Angina externa. Russel. CEcon. Nat.
Ourles. Oreillons. F.
Branks. Scottish.
Mumps.

4. PARisTHMiTis. Rcdness and swelling of the fauces; with

painful and impeded deglutition.
Paristhmia (vtc^ierifA'a.) Hippocr. Galen.
Cauma parisLhniitis. Young.
Cynanche. Auct. Grca. Sauv. Cull. Sag. Linn.
Angina. Aucf. Lat. Hojffm, Boerrh. Vog.
Khenauk. Arab.
Kehlsucht. G.
Esquinancie. F.
Squinancy. Squinsy. Quinsy.
» Tonsillaris. Swelling of the mucous membrane of the
fauces, and especially of the tonsils : redness florid-
fever a cauma.
Synanche. Auct. Groac.
Cynanche tonsillaris. Sauv, Cull.
Cynanche faucium. Parr,

4. Empresma Paristhmitis : from ttu^cc and iffSfiof. literally morbus
faucium^ ov throat-affection. In J iippocrates paristhmia : Trtt^iaSfctx —
(pXiyt*.woi.i tm x«Ta t«v Krifcov ^a^aav. The term was used among the
Greeks, as m the present system, genericaily. The later Greek
physicians gave different names to Ihn different species of the genus :
and hence we meet with cynanche, synanche, and parasynanche ;
the idea common to all which is that of angina or strangulation,
while the prefixes to the terms are of doubtful meaninjg. See Gal.
vi. 324. Cels. De Angina. Aetius attempted to justify cynanche, but
Caelius Aurelianus and Paulus used synanche after Celsus. The
Latins employed angina in the same broad or generic sense as Hip-
pocrates paristhmia ; quinsy is used in a parallel latitude among our-
selves. Sauvages conjectures, and there is some ground lor the
opinion, that the synanche of the Greeks was the common quinsy
(synanche, or paristhmitis tonsillaris) of the present day ; their pa-
rasynanche, the quinsy of the pharynx (c. or p. pharingea :) and
their cynanche, the croup of modern times, bronchitis ore trachea-
lis. See further upon this subject, the PreUminary Dissertation,
sect. ii.

GE. VII.] NOSOLOGY. 135

Anginae inflammatoriae. Boerh.
Common quinsy.
6 Maligna. Crimson redness of the mucous membrane

of the fauces and tonsils ; ulcerations covered with

mucous and spreading sloughs, of an ash or whitish

hue ; fever a typhus.
Cynanche maligna. Cull.
Cynanche maligna. C. ulceros. a, C. gangraenos. b.

Sauv.
Angina ulcerosa ; maligna ; gangrsenosa. Auct. Var.
Ulceros : ulcerated : malignant sore throat.

Frequently epidemic ; generally contagious.
Found often as a symptom in rosalia or scarlet fever.
y Pharyngea. Redness florid, and especially at the lower

part of the fauces ; deglutition extremely difficult and

painful ; fever a cauma.
Parasynanche. Axict. Grcec.
Cynanche pharyngea. Sauv. Cull. Eller.
Anginae inflammatoriae, sp. 4. Boerh.
5. BRONCHITIS. Breathing sonorous and suffocative ; voice
harsh ; ringing cough ; fever a cauma.
Cynanche. Auct. Grcec.
Cynanche trachealis. Sauv. Cull.
Cynanche stridula. Parr.
Cynanche laryngea. A^tct. Var.
Anginae inflammatoriae. Boerh. sp. 1.

Dr. Cullen is said to have prided himself upon having grouped an
extensive natural family of diseases under the term cynanche. Parr,
art. Angina stridida, denies that he has done so ; and adds, that
" self-complacency had never so baseless a foundation. The spe-
cies," continues Parr, " agree in no one principle but affection of the
parts connected with the neck."" This remark is too sweeping : it
may apply to Cullen's species of c. trachealis (croup,) and c. paro-
tidoea (mumps:) but the rest must be exempted from its severity.
And it is not a little ludicrous to observe Parr, after passing this
censure in his article Angitia, under which he considers the disease
in its different bearings, completely altering his views by the time
he reaches the article Nosology : for here we find, in the first place,
the term angina banished, and that of cynanche adopted in its stead ;
and secondly, croup and mumps, which are chiefly objected to in the
preceding quotation as divisions of cynanche, not only made divisions,
but snnk from species, in which they occur in Cullen, into varieties.
The present arrangement follows the Cnllenian, as far as perhaps it
ought to do, and only quits it where the latter seems to demand a
change.

136

iNOSOLOGV. [CL. UI.-OK. II.

Angina poljposa. Mitchd.
Expectoratio solida. Darw.
Cauma bronchytis. Young.
Angina canina. Zacut, Lusit.
Croup.

In the American states this disease usually receives
the name of hives^ a corruption of the term heaves, which
is probably so called from the heaving or violent efforts
of the muscles of the chest and abdomen, which takes
place in breathing during its course. Hosuck. Amer.
Med. and Phil. Reg. Vol.^ii. p. 41.

The aperture of the glottis is twice as large in adults
as in youth before puberty ; and hence one cause of the
great danger of sufibcation from this disease in children,
in whom the aperture is often not more than a line and
a half in breadth. See Ridicrand Elem. de Physiol,
ch. xi. See also BallUe^s Morb. Anat. Fasc. II. pi. 2.

The concreted eifusion, formed in the trachea, and
so profusely coughed up, often extends through the
whole range of the air-vessels as far as the eye of the
anatomist can trace them.
G. PNEUMONITIS. Obtuse pain in the chest : constant difficulty
of respiration alleviated by an erect posi-
tion ; tumid, purple face or lips ; cough,
generally moist, often blood}': pulse usu-
ally soft.

Paristbmitis is here preferred to paristhnvia, as used by the Greek
writers, only because it corresponds with the general termination
given to the species of the present genus. But either is preferable
to angina ( xyX'^m -I '"'' cJwak, strangle''"') ov cynanche {tcvvxyxvi, literally
dog-choak) on account of their greater elegance, and iheir contain-
ing the name of the organ affected.

Dr. Cullen, in his remarks on cynanche maligna, seems to suppose
that the Spaniards distinguish this peculiar kind of sore throat by
the name of garrotillo ; and Dr. Parr has added, in bis article An-
gina gangrccnosa., that they have given this n;ime to the malignant
sore throat, from the shrill barking sound which accompanies the
worst sort : as though garrotillo imported barking. The fact is, that
garrotillo is precisely synonymous with angina and qttinsij, or as the
French write it, csquinancic, from which our term is derived. All
denote choaking suffocation, or a sense of strangling; the radical
Spanish verb is garrotar, '• to choke, bind tight, especially about
the throat, to strangle ;" and all are used equally in a generic sense.
and signify suffocating sore throats of every kind.

«E. VII.] NOSOLOGY. 137

Peripneumonia. Sauv. Linn. Vog. Sag. Machr.
Pneumonia peripneumonia. Cull.
Pneumonitis. Mich. Bourgard. Diss. 1754.
Pulmonaria. .^uct. Vur.
Zatal-beyn. Arab.
Entziindung der lungen. G.
Peripneumonie.

Peripneumony. Inflarmnation of the lungs,
» Vera. The fever a cauma ; pain severe, little expec-
toration in the beginning.
Peripneumonia vera. Huxh. Cull,
Peripneumonia pura. Sauv. Morgagn.
Peripneumonia simplex. Macbr.
6 Maligna. Fever a synochus or typhus. The debility
so extreme from an early stage of the disease, that
; the pulse ceases on the pressure of the finger; and

the vascular action is too weak to accomplish ex-
pectoration. Often epidemic.

Said to be an erysipelatous affection of the lungs,
Sarcone^ Istoria ragionata, &c. Ludwig, Adversa-
ria. Baglivi, A pp.
Peripneumonia putrida, sp. 3. — p. maligna 4. — p. ty-
phodes 5. Sauv,
y Notha. Great secretion and expectoration with a
mild cauma. Probably in many instances a catarr-
. hal affection : chiefly occurring in advanced life, or
in those who have weakened their constitutions by
excesses.
Peripneumonia notha. Sydenh. vi. 4. Bocrh. Coze,

Journ. Med. 1790.
Catarrhus suffbcativus. Auct. q?

Pneumonitis is found also, occasionally, as a symp-
tom in rheumatism, phthisis, various exanthems, as
small-pox, measles, miliaria ; in lyssa, and rickets.
See Musgr. xi. 5. Sydenh. passim. Morton. Phthi-
siol. iv. 41. de Variol. vii. 64. Allion, de Morb. Mill,
p. 107. Journ. Encyclopedigue, tom. i. 3. Doazam»
Monspel. Often terminates in vomica : sometimes in
empyema.
7. pLEURiTis. Acute pain in the chest; increased during in-
spiration; difficulty of lying on one side:
hard pulse; short distressing cough.
Pleuris. Hippocr. Sauv, Lmn. Vog. Sag. Cull.
Pleuritca febris. Hoffm.
18

138 NOSOLOGY. [CL. IlI.-OR. II.

Passio pleuritica, Ccel. Aw. ^

Jirsanl. Arab.
Seitenwehe. G.
Mai di punta. ItaL
Pleurisie. F.
Pleurisij.

a, Vera. Fever a cauma ; pain felt chiefly on one side.
The inflammation, in this case, commences in that
side of the membrane which lines the ribs ; though
often communicated to the contiguous portion which
covers the lungs,
Pleuritis vera. S'omtj.
Pleuritis sanguinea. Hippocr.
Pleuritis pura. Bagliv. Sydenh.
S Mediastina. Heavy pain in the middle of the ster-
num descending towards its ensiform cartilage;
with great anxiety. The inflammation is seated
obviously in the mediastinum from the symptoms.
Plt'uritis mediastini. Saw.
Pneumonia pleuritis. Cnll.
y Diaphragmatica. Painful constriction around the
praecordia; small, quick, laborious breathing.

These symptoms sufficiently decide that the in-
flammation is seated chiefly in the diaphragm.
Paraphrenitis. Boerh. aph. § 907.
Paraphrenesis diaphragmatica. Sauv.

The terms paraphrenitis and paraphrenesis are de-
rived from the Peripatetic philosophy, which suppos-
ed the seat of the phren (<pg»j») or soul to be the prae-
cordia: whence this last region was denominated
phrenes (<?§£««•) Arist. De Part. Anira. 1. iii. Hippo-
crates, on the contrary, supposed its scat to be in the
brain.

This species is found, occasionally, as a symptom
in typhus, catarrh, rheumatism, worms, pregnancy,
trichoma, miliara, and affections of the liver. Zevlani
De parapleurit. Marlcau de Grandvilliers de pleuro-
peripneum epidem. BInnchi, passim. Schenck. lib.
ii. De Mesery, tom. ii. 314. Morion. Pyret. Hist. viii.
141. Puzos. Traite des depots laiteux. Stabel. de
Plica. Alfion. de Miliaria.
8. CARDITIS. Pain in the region of the heart, often pungent ;
anxiety; palpitation; irregular pulse.
Wlarditis. Sauv. Vog. Cull. Macbr.

GE. VII.] NOSOLOGY. 139

Inflammatio carditis. Parr.
Cauma carditis. Young.
Enziindung dei* hertze. G. -
Inflammation de coeur. F.
■ Injlammatlon of the heart.

See a singular case of this disease in Hewson's Expe-
rimental Inquiries into the Lymph Sjst. Part ii. p. 113.
transcribed from Sir John Pringle's notes. See also
Hunter on Blood, p. 305, 311, 339.
9, PERITONITIS. Pain and tenderness of the abdomen, especial-
ly in an erect posture ; with little affection
of the subjacent viscera, or abdominal walls.
Peritonitis. Vog. Cull.
Cauma peritonitis. Young,

K Propria. The inflammation taking the general range
of the peritonaeum ; pain extreme, often pungent,
with little or no relief from stools.
C Omentalis. With a more sensible swelling in the re-
gion of the omentum.
Omeiui inflammatio, Boerh.
Epiploitis. Sauv. Sag.
Omentitis. Fog.
Enteritis epiploitis. Parr.

8. Empresma Carditis. The symptoms have a considerable re-
semblance to those of pneumonitis; and Cullen affirm? that he has
often met with the disease evincing no other symptoms. It is pro-
bably on this account that Linneus has taken no notice of it in hisar-
rang-ement. Vogel's definition is founded ahogether upon this view,
" cordis inJlammatio fere ut in peripneumonia." The general con-
nexion of the pleura with all the thoracic organs, some part of which
seems necessarily to suffer when any one of them is affected, must
give something of a family character to the whole group of thoracic
diseases. It is singular that Vogel, having thus admitted the diffi-
culty of distinguishing carditis from pneumonitis by its symptoms,
should have added pericarditis as a distinct disease from the former,
referring us for its symptoms to those of mediastina, e. pleuritis € of
the present nosology. In a strictly anatomical view it may perliajjs
be at times a separate affection ; but, so far as regards the symptoms,
we know nothing of such distinction, and it would hence be idle to
allow it.

9. Empresma Peritonitis. The subjacent viscera, or parietes of the
abdomen, if affected at all, are only affected secondarily. " If the
peritoneum, which lines the cavity of the abdomen, inflames, its in-
flammation does not affect the parietes of the abdomen : or if the
peritoneum covering any of the viscera is intlamed, it does not af-
fect the viscera. Thus the peritoneum shall be universally inflamed.

140 NOSOLOGY. [CL. IIl.-OR. II.

7 Mesenteries. Pain deeper seated, and more immedi-
ately in the mesenteric region ; external tender-
ness less than in the preceding varieties.
Mesenteritis. Vog.
Enteritis inesenterica. Sauv. Parr.
Puerperal fever is sometimes made another variety of
this species: but it belongs rather to typhus. See
Enecia Typhus.
10. GASTRITIS. Burning pain at the pit of the stomach, in-
creased by swallowing ; rejection of every
thing; hiccough; oppression and dejection
of mind ; fever a synochus.
Gastritis. Sauv. Linn. Vog. Sag, Cull.
Ventriculi inflammatio. Boerh.
Cauma gastritis. Young.
Inflammatio gastritis. Machr. Parr.
Entziindung der magens. G.
Inflammation de Pestomac. F.

as in the puerperal fever, yet the parietes of the abdomen, and
the proper coats of the intestines shall not be affected : on the
other hand, if the parietes of the abdomen, or the proper coats of
the intestines, are inflamed, the peritoneum shall not be affected."
Hunter, on Blood, p. 244.

10. Empresma Gastritis. "If the stomach is inflamed, the patient
feels an oppression and dejection through all the stages of the in-
flammation ; simple animal life seems to be hurt and lessened, just
as sensation is lessened when the brain is injured; the pulse is gene-
rally low and quick, the pain is obtuse, stronpf, and oppressing, such
as a patient can hardly bear." Hunter, on iilood, p. 234.

10 a E. Gastritis Mhcesiva. This comprises the genuine adhesive
inflammation, of which the following remarkable case, recorded by
Mr. Cruikshank, is quite in point, " A young lady died after two or
three days illness: before this she had been in perfect health. I
was called in, but slie was dead before I got to the house. From
her history I was at a loss to account for her death : but on opening
the abdomen a day or two after, I found the contents of the sto-
mach in that cavity ; that they had produced peritoneal inflamma-
tion, and killed. On examining the stomach, 1 found a hole in it
large enough to admit the end of my finger : this hole had been
formed by absorption of part of the substance of the stomach from
scrophulous ulceration : its edges had adhered by inflammation to
the under surface of the small lobe of the liver. This inflammation
was evidently raised by the powers of the body to prevent the ac-
cident which happened ; and if no violent vomiting had taken place,
and torn this adhesion at this ])articular time, she might have lived

GE. VII.] NOSOLOGY. l4l

Inflammation of the Stomach.
« Adhaesiva. Pain very acute : fever violent.
Gastritis phlegmonodea. Cull.
Gastritis legitima. Sauv.
C Erythematica. With an erythematous blush extend-
ing to and visible in the fauces ; pain more mode-
rate; fever less violent: pulse low and quick.

The species, under one of its two varieties,
found also as a symptom, occasionally, in aphtha,
measles, small-pox, and other exanthems ; perhaps
also in repelled herpes, scabies, and similar erup-
tions. Eller. de Cogn. et Cur. Morb. § 11. Hoffm.
de Febr. Stem. Sauv. in loco.
II. ENTERITIS. Griping pain in the belly, with tension, tender-
ness and vomiting ; fever a synochus.
Enteritis. Sauv. Linn. Vog. Sag. Cull.
Intestinorum inflammatio. Boerh.
Chordapsus. Galen.
Cauma enteritis. Young.
Entziindung der darmen. G.
Inflammation des boyaux. F.
Injiammation of the Bowels.

for years notwithstanding the ulcer." Anat. of the Absorb. Vess.
p. 122.

It is from this common tendency of the genuine empresma, that
the author has been induced to distinguish the present from the
subdivision which follows, by the name of erythematica. Dr. Cui-
len's term is phlegmonodea., which is not quite true to his own cha-
racter of phlegmon — " in fastigium plerumque elevato, scepe in apos-
tema abeunie ; dolore scBpe pulsatili.'''' CI. I. Ord. ii. Gen. vii. Phlo-
gosis Phlegmone.

10. C E. Gastritis Erythematica. For a correct distinction be-
tween the two subdivisions which occur in this and the next species,
however, we are chiefly indebted to Dr. Culien, but who advances
them, unnecessarily, to the rank of species Mr. John Hunter has
added great strength to Dr. Cullen's opinion concerning the second
variety. "There is," says he, "an inflammation which aitacks in-
ternal canals, which is classed with the erysiptslatous ; but how far
it is the same I do not know : it is certainly not the suppurative.
Whatever it is, it may be considered m some of its effects to be in
direct opposition to the adhesive and the suppurative inflammations;
for where the adhesive most readily produces adhesions, there the
erysipelatous does not, as in the common cellular membrane ; and
where the adhesive seldom takes place, excepting from extreme
violence, there this inflammation (if erysipelatous) has a tendency

142 . NOSOLOGY. fcL. IIl.-OR. II.

« Adhaesive. Pain very acute; vomiting frequent ; ob-
stinate costiveness; fever violent.
Enteritis iliaca. Sauv. sp. 1.
Enteritis rolica. Sauv. sp. 2. Boerk. 963.
Enteritis phlegmonodea. Cuil.
C Erythematica. Pain inoi-e moderate; fever less vio-
lent; little voniiiing ; di irrhoea.

The species, under one of the two varieties,
found also, occasionally, as a synriptom in intestinal,
ventral, inguinal, and other hernias.
12. HEPATITIS. Tension ; soreness, and pain in the region of
the liver ; pain about the right shoulder : dif-
ficulty of lying on the left side.
Hepatitis. Gal. et .^ucf. Recent.
Jekur fessadi. Pers. Tvrk.
Entziindung der leber. G.
Inflammation du foye. F.
Inflammation of Ihe Liver.

Properly speaking, /<'JS'V;?a only is Arabic, and denotes
malum, corruptin ; for the Arabic term for the liver is
kebed. literally imported from the Hebrew ni3, whence
also the Syriac kebida. It has been already observed,
that it is from the Persi in term jekur, that the Latin
term jecur is probably derived, as it is from the Greek
term i,-rxf that the same tongue has co})ied hepar.

to produce adhesions, as in canals or outlets; it also opposes, in
some degree, the su|)pi]rative, in being backward in producing sup-
puration even in those places where suppuration most readily takes
place, such as canals and outlets; for there, as above observed, it
more readily throws out the coagulating lymph. Whatever the in-
flammation may be, it is certainly attended with nearly the same
kind of constitutional aff ct.on. The fever in both appears to be
the same: viz. accompanied with debility languor, &c " On Blood,
p. 270.

The gastritis erysipelatosa of Sauvages, ^p. 4, which he copies
from Riverius, is improperly thus named : for, as Dr. Pullen has re-
marked, it clearly belongs to the first or adhesive subdivision, of
which it has all or nearly all the characters.

11. et E. Enteritis MhvRsiva. The nature of the disease depends
chiefly upon the patient's idiosyncrasy; but much also upon the sea-
son of the year and temperament of the almosphere. And some-
times the modifying causes are so balanced as to leave it doubtful
which variety will be established. Master P — , a healthy and ac-
tive Ijoy thirteen years old, was attacked with marked symptoms of
enteritis in July 1805, but of so mixed a character as to produce un-

GE. VII.] NOSOLOGY. 143

« Aciita. The specific character decisive; and the
symptoms clearly marked.

Hepatitis acuta. Cull.
C Ciironica. The specific character obscure; and the
existence of the disease suspected from exposure to
its causes; and an occasional recurrence of the pa-
thognomic symptoms, accompanied with a slight de-
gree of fever.

Hepatitis chronica. Cull.

Hepatitis obscura. Sauv.

13. SPLENITIS. Heat, fulness, and tenderness in the region of

the spleen : pain upon pressure.
Splenitis. Auct.

Lienis inflammatio. Boerh. Sennert.
Entziindung der miltz.
Inflammation de la rate. F.
Inflammation of the Spleen.

The splenalgia of authors is usually a shght attack
of this species with some small degree of fever. Para-
bysma splenica, agnc-cake, is a frequent sequel of sple-
nalgi.

14. NEPHRITIS. Pain in the region of the kidneys and ure-

' ters ; frequent micturition ; vomiting ; numb-
ness of the thigh on the affected side ; retrac-
tion of the testicle.
Nephritis. Auct.
Renum inflammatio. Sennert.
Entziindung der nieren. G.
Inflammation des reins. F.
Inflammation of the Kidneys,

Found occasionally, also, as a symptom in nephritic
calculi, and rheumatism. Hoffm. tom. iii. Meysery ii.
374.

certainty for the first two or three days. The abdomen was tense
and tender, the intestinal canal painful through the greater part of
its extent ; the pulse was quick and moderately full ; the skin very
hot and dry ;— the blood, when drawn from the arm, without any
buffy appearance ; the sickness incessant, with great oppression and
anxiety. The symptoms continued to increase — the stomach be-
came evidently afft^cted ; an erythematic sloughing appeared in the
throat on the fourth day from the attack ; and on the sixth the pa-
tient died.

12. Empresma Hepatitis. The varieties are taken from Cullen.
Sauvages, on the authority of Amati, has given an erysipelatous

144 NOSOLOGV. [CL. IlI.-OR. II.

15. CYSTITIS. Pain and swelling in the hypogastric region:

discharge of urine painful or obstructed ; te-
nesmus.

Cystitis. Auct. Recent.

Inflammatio vesicae. Hoffm. Sennert,

Cystiphlogia. De Meyzerey. Malad. des Arm.

Entziindung der blase. G.

Inflammation de la vesie. F.

Inflammation of the Bladder.

Often the result of wounds, sometimes of cantharides r

more generally idiopathic.

16. HYSTERiTis. Pain, swelling, and tenderness in the hypo-

gastric region ; heat, pain, and tenderness of
- ^* the OS uteri ; vomiting ; pulse quick and low.

Hysteritis. Linn. Vog. Cull.

Metritis. Sauv. Sag.

Inflammatio uteri. Senntrt.

Entziindung der mutter. G.

Inflammation de la matrice. F.

Injlammation of the Womb.

« Sfrnplex. The organ being unimpregnated. Pain
permanent, circumscribed, throbbing ; fever a cauma.

S Puerperarum. Pain less acute, less circumscribed ;
flow of urine difficult : fever a synochus or typhus.

17. ORCHITIS. Pain and swelling of the testicle; nausea or

vomiting ; depression of spirits ; pulse quick,

somewhat low.
Inflammatio testium. Auct. Var.
Hernia humoralis. Auct. Var.
lnfammatio?i of the Testicle,

The stomach peculiarly sympathizes with this aftec-
tion ; and it is hence often cured by vomits when all
local applications have prov.cd ineflfectual.

(erythematic) hepatitis ; as Lommius, Observ. lib. ii. has done a simi-
lar variety of pneumonitis; but the parenchymatous viscera do not
seem to be subject to an inflammation of this description. " Me,
saltern, judice," says, Cnllen, " erythema non nisi superficies illas
internas quas tegit epithehon et tunica vlllosa epidermidi externae
continua, et analoga, afficere potest." The observations of Mr.
J. Hunter just quoted under empresma and cmpresma gastritis, are
in pf rfect accordance with this opinion.

Gen. VIII. Ophthalmia. This term is used in very different lati-
tudes by different writers. Sauvages, Linneus, and Sagar, make it
parallel with cephalalgia or cephaliB ; and consequently expressive

GENUS VIII.

OPHTHALMIA.

Pain and redness of the eye or its appendages ; intole-
rance of light ; flow of tears or other excited secretion.
Ophthalmia. Sauv, Linn. Plenck et Alior,
Oculorum inflammatio. Vog,
Inflammatio oculorum, Hoffm.
Ophthalmites- Vog,
Cauma ophthalmitis. Young*
Sahik. Arab.

Augenentziindung. G. .'"'^ -•

Ophthamie. F.

Ophthalmy. Injlammation of the Eyes.
1, TARAXis. The tunics of the eye-ball chiefly mflamed : in-
creased secretion of tears.
Ophthalmia humida. <S^ Yvts.
Ophthalmia vera. Senncrt.
Epiphora. Galen.
Taraxis. Paul. JEgin. Aetii.
Chemosis. Aetii.

Ophthalmia Chemosis. O. Taraxis. O. humida. Sauv.
Ophthalmia membranarum. Cull.
Lachrymose Ophthalmy.

« Mitis. Limited to the surface : pain tolerable : with-
out head-ache.

of any ache of the eye without reference to fever or inflammation j
among all whom it occurs as a genus under the class dolores. By
Vogel, CuUen and Macbride it is limited to inflammatory affections
of the eye : occurring as a genus under the two former, and as a
species under the latter. In Parr and Young it is found also as a
mere species ; the second denominating it ophthalmitis, consonantly
with the common termination of the inflammatory diseases of internal
membranes and organs. Yet it is difficult to say what precise des-
cription of ophthalmy Dr. Young adverts to by his Cauma ophthalmi-
tis, since he merely refers us for an explanation to another genus
and species in his arrangement, which he denominates inflammatio
specifica ; under one subdivision of which he enters Dr. Cullen's
ophthalmia ; as though he intended that the two should be synony-
mous : in which case, however, there seems little or nothing left
for cauma ophthalmitis, as Cullen's ophthalmia is purposely de-
signed to cover every inflammatory affection of the eye.
19

J 4(3 NOSOLOGY* [c!L. III.-OR. II.

Taraxis. Phnck,
C Acuta. Extending to the lower part of the eye-ball ;
sometimes commencing there ; pain burning ; tears
perpetual and acrid ; intolerable head-ache.
Chemosis. Phnck.

2. PURULENTA. The internal surface of the palpebrae associat-

ing in the inflammation of the eye-ball ; co-
pious secretion of a purulent fluid.
Purulent Ophthalmy* Ware.
« Epidemica. The disease epidemic ; inflammation
rapid and destructive ; head-ache intolerable ; often
succeeded by delirium ; at times remittent.
Ophthalmia epidemica. Wilder. Stutg. 1787. Plenck,
Egyptian Ophthalmy. Pozuer. Vetch. Edmonstone.
C Metastatica. Apparently produced by a sudden sup-
pression of catarrhal, blennorrhoic, or other morbid
discharge. The secretion often greenish. Swediaur,
Scarpa. St. Yves. Pearson. Edmondstone Ware.
Ophthalmia catharrhalis. O. gonorrhoica. Plenck.
y Intermittens, Marked by regular intermissions. Near-
ly allied to the epidemic variety. Probably produ-
ced by marsh miasm.
Ophthalmia periodica. Plenck.
S Infantium. Appearing suddenly, and without any os-
tensible cause, in new-born infants : the palpebrae flo-
rid, and peculiarly tumid.
Purulent Ophthalmy of new-born children. Ware.

3. GLUTiNosA. The inflammation chiefly seated on the tarsus ;

its sebaceous glands secreting a viscous and
acrid fluid that glues and ulcerates its edges,
and irritates the eye.

Ophthalmia tarsi. Cull. Parr.

Psorophthalmia. Plenck. Ware.

Oculi palpebrarum scabies pruriginosa. Castelh

Augenlieder fleckte. G. See Janin. Uber das Auge.

4. CHRONICA, Eye weak and weeping after the inflammation

The term in the present arrangement is used in its limited sense,
as importing inflammation accompanied with local pain. It might
perhaps have been placed as a species under empresma, in which
case it should have been written ophthalmitis : but it has various cha-
racters peculiar to itself, as well in regard to its symptoms as to the
seat of the organ, which seem to entitle it to the rank of a distinct
genus, and it is thus arranged accordingly.

OE, VIII.] NOSOLOGY. i47

has ceased ; redness permanent, increased hy
slight causes.
Lippitudo. Auct, var.
Ophthalmia chronica. Auct, Alior.
Remed. Arab.
Zjger-augen. G.
Chassie. F.
Blear-eye. Lippilude.

Often a relic or sequel of the preceding varieties ; and
best relieved by gentle stimulaius and astringents, as
cold water, solutions of camphor, zinc, alum, lead 5 slight
illinations of French brandy, laudanum, or the nitric
oxyd of mercury in the form of an ointment.

Sometimes the eye assumes a general redness without
pain, which is the ophthalmia indohns of Richter, Janin,
and Gendron. See Richter, Chirargische Bibliotheck,
Band i. stiick. 4. Gendron, Traite des maladies des
Yeux, torn. ii. p. 38. Paris, 1770.

Ophthalmy is also occasionally found as a symptom
in catarrh, scrophula, syphilis.

GENUS IX.

CATARRHUS.

Inflammation of the mucous membrane of the fauces, of-
ten extending to the bronchia and frontal sinues ; in-

Gen. IX. Catarrhus. K«T«ppoa5 : " defluctlo :" from xetrx and p£6»,
" fluo." This term, like ophthalmia, has been used in various senses
and latitudes by different authors. Schneider and Hoffman show a
disposition to extend it to inflammation of mucous glands in gene-
ral : and Parr, enticed by such an example, has made it a genus for
including not only what is commonly understood by catarrh, but the
cough of old age, which he admits is without febrile action, croup,
dysentery, phthisis, cystirrhoea, leucorrhcea, gonorrhoea, and one or
two others. This is the widest acceptation of the term: the narrow-
est is that of the old pathologists, who thus distinguished between
three separate terras which are now regarded by many writers a?
synonymous.

Si fluit ad pectus, dicatur rheuma Catarrhus ;
Ad fauces, Bronchus ; ad nares esto Coryza.

148 ^fOSOLOGY. [cL. III.-OR. IL

farction of the nostrils ; sneezing, and for the most part
a mucous expectoration, or discharge from the nose.
Catarrhus. Hippocr. Sauv. Vog» Sag. Cull.
Coryza. Sauv. Linn. Vog.
Rheuma. Sauv. Sag.
Catarrh.
1. COMMUNIS. Fever slight; mucous discharge considerable,
Catarrhus benignus. Sauv.
Coryza catarrhalis. Sauv.
Rheuma catarrhale. Sauv.
Gravedo. Cels. et. Auct. Lat. Linn.
Catarrhus a frigore. Cull.
Febris remittens catarrhalis. Machr.
Zukam. Ar. Pers.
Erkaltuns;. G.
Infreddatura. Ital.

This couplet is founded, perhaps, upon Galen's account of these
affections, De Sympt. Cans. lib. iv. cap. iii. § 4 ; but it does not follow
up the Greek distinction into all its ramifications ; for the Greek
physicians, as he tells us, had also other names for the defluxion
when it chiefly attacked other parts in the neighbourhood : as aci-
nus, when the uvula was the seat of affection, antiadse, when the
tonsils, and parJsthmia, when the attack was common to the fauces.
For all these Celsus employs the Latin term gravedo, between
which, however, and coryza, he observes that there is an evident
difference. It is this difference which is endeavoured to be explain-
ed in the present system, in which coryza is made to import nasal
defluxion without pyrexy. Celsus takes no notice of the term ca-
tarrh. In this day catarrh was changed by the Greek writers to
catastagmus.

Sauvages has only deviated from the rule contained in the above
Latin couplet by omitting bronchus, and employing catarrhus in its
stead, and rheuma in the stead of catarrhus ; so that with him rheu'
ma imports a cold or febrile defluxion of the chest ; catarrhus the
same affection of the fauces, and adjoining organs ; and coryza the
same of the head or nostrils.

Cullen has regarded rheuma, coryza, bronchus, and catarrhus, as
synonymous terms scarcely indicating varieties of the same disease.
'J he arrangement ot Dr. Cullen, however, did not allow him to place
bex, tussis, or cough any where else ; and he has hence regarded
this affection also as synonymous with catarrh. Here the present
system differs from him, as it does likewise in separating coryza
from the list of phlogotic affections. Cough is not necessarily a
febrile or inflammatory disease, though it may be occasionally a
symptom of such disease. Cough, therefore, under the Greek term
hex, is removed with coryza, to class ii. JPneumatica, where they will

GE. IX.] NOSOLOGY. 149

Rhume. F.

Gravedo. Old Engl,
Cold in the Head.
2. EPiDEMicus. Attack sudden ; great heaviness over the
eyes ; fever strikingly depressive ; epide-
mic,
Catarrhus a contagio. Cull.
Catarrhus epidemicus. Sauv,
Rheuma epideuiicum. Sauv,
Influenza.

For an excellent chronological table of the best wri-
ters upon the subject, from the Cronica Meteorologica
Tuscana of 1323, by Targioni Tozzetti, to Saillant,
Tableau des Epidemics catarrhales, see Cullen's Synop-
sis, in loco.

Catarrh is also found occasionally, as a symptom in
measles, small-pox, worms, dentition, rheumatism.

perhaps be allowed to occupy more correct and natural posts than
in the present phice.

Dr. Crichton and Dr. Young have sunk catarrh into a species of
inflammation or inflammatory fever; the genus of the former being
somewhat unclassically denominated phlegmasicE stheniav, and of the
latter cauma. In this view of catarrh it would find its place, under
the present arrangement, as a species of empresma. But for the rea-
son that the author has ventured to make ophthalmia a distinct genus,
he has also ventured to do the same with respect to catarrhus. It
has sufficiently striking characters for its present rank ; and is of too
complicated a nature for a mere species.

2. Catarrhm spidemicus. Dogs and horses are peculiarly subject
to a violent and frequently fatal species of this disease ; in most in-
stances highly contagious or epidemic. This, among ourselves, is
vulgarly known by the name of distemper, snaffles or rather snuffies :
among nosologists it :s called catarrhus caninus. It is a singular,
and .ippears to be a well ascertained fact, that dogs which have un-
dergone this catarrh never generate lyssa or canine madness, though
they are capable of receiving it by contagion. Hence lyssa is un-
known in South America, notwithstanding the prodigious number of
dogs kept in many parts of it for the express purpose of eating up
the flesh of the wild oxen and buffaloes that are shot for the value
of their hides; and shot too in such abundance, that the atmosphere
would otherwise be loaded with putrid exhalations. In South Ame-
rica the distemper or canine catarrh is more prevalent, and perhaps
more fatal than any where else ; half the dogs being supposed to
4ie of it while puppies.

150 NOSOLOGY. [CL. UI.-OR. U.

GENUS X.

SPARGANOSIS.

Pale, tense, glabrous, diffused swelling of a limb : great
tenderness ; inflammation subcutaneous, unsuppura-
tive.
Sparganosis, Dioscor.
J, PUERPERARUM. Occurring, for the most part, during the se-
cond or third week after child-birth ; li-
mitted to the lower extremity, and chiefly
to one side ; exhibiting to the touch a
feeling of numerous irregular prominen-
ces under the skin ; fever a hectic.
Phlegmatia lactea. Sauv. Levret.
Phlegmatia dolens. Hull,

Gen. X. Sparganosis. S7r«gv«v«(7/; : from o-jragy***, " to tumefy
and distend :" tumeo et distentus siim^ as rendered by Scapula. This
term is taken from Dioscorides, as already observed in the note on
Phlegmone mammae. It is here designed, however, to distinguish
only one of the numerous and heterogeneous diseases which Dios-
corides has included under it, from a notion that all are the result
of a suppression, miscombination, or misdirection of the milk. Ab-
scess in the breast, phlegmone mammae, is not always connected
with the state of the milk ; and the present species, though usually
referred to this cause, still less frequently connected, and perhaps
never. The latest and best writers upon the subject, Mr. White,
Mr. Trye, Dr. Ferriar, and Mr. Hull, concur in deriving the disease
from lymphatic effusion, or an inflammation of the lymphatics, or of
the lymphatic gland of the side affected. Probably both concur in
its production, which is Dr. Hull's hypothesis; at the same time
the fever seems to be idiopathic, and the effused lymph peculiarly
thick and glutinous, constituting a critical deposit ; its increased glu-
tinosity resulting perhaps from the tendency which the general
frame at this time possesses of producing genuine milk, and milk-
like or albuminous secretions in various parts of the body, as foi'
example in the peritonaeum during typhus puerperarum ; and in dif-
ferent parts of the hypogastrium, as described by i uzos, in his
Traite des Accouchemens, under the name ofDepdt laiteux dans I'hy-
pogastre.

That sparganosis is not dependent upon the state of the mammary
organ, is obvious from its occurring in cases where there is no sup-
pression of milk ; and from its being found equally in the weak and
the strong, the lean and the corpulent, the sedentary and the active,

GE. X.] NOSOLOGY. l5l

Anasarca serosa. Cull.

Ecphyma oederaaticum. A. Young*

Ecchymoma lymphatica. Parr. Art. Lymphoeductus.

Ischias a sparganosi. Sauv,

Depot laiteux sur la cuisse. Puzos.

Lait repandu. F,

Milch-streichem. G,

Milk-spread.

GENUS XL

ARTHROSIA.

Inflammation mostly confined to the joints ; severely pain-
ful ; occasionally extending to the surrounding mus-
cles.
Arthritis. Auct. GrcBc.

the young and the middle-aged, those who suckle, and those who
do not. The edematous affection that takes place in the ankles af-
terwards is a mere sequel of the disease, dependent upon vascular
debility ; and hence Dr. Cullen seems not less improperly to regard
sparganosis as a species of anasarca, (anasarca serosa) than others
who have regarded it as a species of milk-affection. The author
has, at the time of writing, a lady under his care, severely affected
with sparganosis, of good natural constitution, and with* profuse flow
of milk ; her age twenty-two : has lain in three weeks.

Gen. XI. Arthrosia. From «g^g»«, " to articulate," whence
arthrosis, arthritis, and various other medical derivations. The usu-
al term for the genus of diseases before us, among the Greek phy-
sicians, was arthritis^ which the author would have continued, but
that, for the sake of simplicity and regularity, he has been anxious
to restrain the termination itis to the different species of the genus
empresma^ comprising the membranous and parenchymatous inflam-
mations ; whence arthrosia is employed in its stead, and precisely in
its original extent of meaning.

Arthritis, among the Greeks, was used generically to import ar-
ticular inflammations, or painful joint-tumours of every sort. Al-
most every sort, having, however, in recent times, been regarded
as a distinct genus of diseases, it has frequently been a question to
which of them the Greek term should be applied. Hence, as will
appear from the different synonyms in the text, some writers have
limited it to gout, others have more or less extended it to gout and
rheumatism j others again have made it embrace white-swelling ;

152 NOSOLOGY. [CL. IlI.-OR. M.

Arthritis. Sauv. Parr. Art. Nosol.

Articular Inflammation*

Joint'ttche.

while a fourth class of writers, in order to avoid all obscurity and
dispute, have banished the term ahogether.

Now gout, rheumatism, whether acute or chronic, and white-
swelling, however they may differ in various points as well of symp-
toms as of treatment, have striking characters that unite them into
one common family or genus. Gout and rheumatism are so nearly
allied, in their more perfect forms, as to be distinguished with con-
siderable difficulty ; and, in many instances, rather by the collateral
circumstances of temperament, period of life, obvious or unobvious
cause, antecedent affection or health of the digestive function, than
from the actual symptoms themselves. Stoll maintains that they are
only varieties of the same disease, Med. Rad. v. p. 465. Ber-
gius, that they are convertible, Svanne Suar om Gikt. White-swell-
ing, in one of its varieties, is now uniformly regarded as a sequel of
rheumatism, or the result of a rheumatic diathesis : while the oth-
er variety cannot be separated from it. All these therefore neces-
sarily form one common genus, and are correctly so arranged by Dr.
Parr.

Cullen has justly observed, after Sauvages, that properly speak-
ing, there is but one species of gout, the subdivisions being mere
varieties. This one species, however, he has incorrectly made a
genus, and then, having entered his subdivisions under it as varieties,
he has, in fact, given us no species whatever. Macbride has given
us both genus and species as well as varieties ; but then his species
are only parallel with the varieties of Cullen, while the genus of
both of them should have been a species alone. The subdivisions
of Macbride, which he calls species, are simpler than those of
Cullen ; and the present arrangement, therefore, though it does not
exactly adopt them, is in some degree guided by them. Atoiiic
gout, which is the name of Cullen's second variety, might just as
well include his retrograde gout, or third variety, and perhaps his
aberrant^ or misplaced gout, which forms his fourth.

The varieties of arthrosia hydarthrus, are taken from Mr. B. Bell's
treatise on white-swelling.

From the close connexion between gout and rheumatism, Sauva-
ges, and various other nosologists, distinguish some of the cases of
disguised gout by the name of rheumatic-gout. Mr. John Hunter
warmly opposed this appellation, for his doctrine was, that no two
distinct diseases, or even diseased diatheses, can exist in the same
constitution. Yet it is singular that one of the severest illnesses that
attacked his own person, and which ultimately proved to be dis-
guised gout, podagra larvata, he suspected, in its outset, to be a
rheumatic attack. See Sir Everard Home's Life of Mr. Hunter,
prefixed to his Treatise on Blood, p. liii. compared with p. iv- The

<JE. XI.] NOSOLOGY. 153

1. ACUTA, Pain and inflammation usually about the larger
joints, and surrounding muscles ; often wander-
ing ; urine depositing a lateritious sediment : fe-
ver a cauma.

Rheuraatismus. Sauv. Linn. Vog. Call.

Myositis. Sag. Ploucquei.

Myitis. Cricht.

Cauma Rheumatismus. Y'oimg,

Arthritis Rheumatismus. Parr. Art. Nosol.

Rheumatisrae chaud. F.

LaufFende gicht. G.

Acute Rheumatism.

ec Artuum. Pain chiefly felt in the joints and muscles
of the extremities.

example is highly interesting and curious, as showing the singular
forms which this morhid Proteus sometimes affects, and the various
seats it occupies : as also that a life of temperance and activity is no
certain security against its attack : for Mr. Hunter at this time had
drunk no wine for four or five years, and had allowed himself but lit-
tle sleep at night. The reader may turn to some very excellent
observations of Mr, Hunter on this disease, in his Treatise on Blood,
p. 265—268.

Gout is one of the maladies which seems to have been common to
England in its earliest ages of barbarism. It is frequently noticed
by the Anglo-Saxon historians, and the name assigned to it is fot-
adl, (foot-ail.) In the Cottonian MSS. at the British Museum, Lib.
Fitell. c. 3, we have the following prescription, which was once re-
garded as a specific : " Take the herb datulus ortitulosa, which we
call greata cranleac (a species of iris or flag-flower.) Take the
heads of it, and dry them very much, and take thereof a penny-
weight and an half; and the pear-tree and roman bark, and cummin,
and a fourth part of laurel-berries ; and of the other herbs half a
penny-weight of each, and six pepper-corns, and grind all to dust ;
and put two egg-shelis full of wine. This is true leech craft. Give
it to the man to drink till he be well.'"

1. Arthrosia acuta. One of the best tracts upon this subject is
that of Dr. Haygarth's Clinical History of the Acute Rheumatism^
contained in his '-• Clinical History of Diseases," published in 1805.
It gives the fair result of a considerable extent of practice condensed
into a small compass, and arranged in a tabular form, from notes
taken by himself during a period of thirty-eight years. Of 470
patients, only 170 are stated to have had any fever, amounting to
about a third of the whole ; and hence, perhaps, the majority should
rather be regarded ns appertaining to the second species of the
present arrangement. The tables contain a larger list of males than
of females, probably from the former being more generally exposed
20

154 NOSOLOGY. [cL. III.-OR. IL

Veje-omefasil. Arab.

Said, among other curious remedies, to be relieved
by the warmth and stimulus of an ants' nest: balneum
formicarum. See Bourgeois, Hebammenbuck, part
ix. cap. 14.
C Lumborura. Pain chiefly felt in the loins ; and shoot-
ing upwards rather than below.
Lumbago rheumatica. Nephralgia rheumat. Sauv,
Zulekkhet. Arab.
LMmbago.
y Coxendicis. Pain chiefly felt in the hip-joint; pro-
ducing emaciation of the nates on the side affected,
or an elongation of the limb.
Ischias rheumaticum. Sauv.
Ischiadum malum. Plouquet.
Huft-wehe. G.
Sciatica.
3 Thoracis. Pain chiefly felt in the muscles of the
diaphragm ; often producing pleuritis diaphragma-
tica.
Pleurodyne rheumatica. Sauv,
Pleuritis spuria. Boerh.

Kasho, Arab, literally spurious pleurisy, as named by
Boerhaave above.
2. CHRONICA. Pain, weakness, and rigidity of the larger joints
and surrounding muscles ; increased by mo-
tion ; relieved by warmth ; spontaneously or

to cold : they embrace persons of all ages, but the greater number
are between fifteen and twenty years of age. In a considerable
majority of cases the joints were the parts principally affected ; in
bome the joints and muscles ; and in a few the latter alone. The
average of the pulse in the above 170 patients was 100, and the
blood always exhibited the inflammatory crust, when drawn. The
most successful remedy was a free use of the bark, as at first pro-
posed by Morton, and afterwards successively by Sir Edward Hulse,
und Dr. Fothergill. It is irom the accurate observation of the last
writer that the author has added in the definition of the disease the
feature of lateritious urine.

1. y J. acuta Coxendicis. Said to be cured by a decoction of the
Linnaia boreahs. Amanit. Acad. vol. vii. art. 149. Rariora Norwe-
giae. Respond. H. Tonning. 1708. This plant, which belongs to
the class didynamia, order angiospermia, is found in the woods oi
our own country ; with campanulate flowers in pairs, nodding, va-
riegated with white and red.

The decoction appears to operate as a sedative and narcotic-

GE. XI.] NOSOLOGY. 155

easily growing cold; fever and swelling slight,
often imperceptible.
Rheumatismus chronicus. j^uct,
Rheumatismus vulgaris. Sauv.
Arthrodynia. Cull.
Arthritis arthrodynia. Parr.
Rheumatisme chronique. F.
Chronic Rheumatism.

The varieties are those of the preceding species, of
which CuUen regards the disease as a mere sequel. It
appears however at times to be idiopathic ; but it is often
difficult to draw the line between the two.
3. PODAGRA. Pain and inflammation chiefly of the smaller
joints ; returning after intervals ; often pre-
ceded by, or alternating with, unusual affec-
tions of the stomach, or other internal parts :
unsuppurative.
Arthritis. Sauv. Linn. Sag. Macbr.
Podalgia. Dioscor.
Podagra. Boerh.
Arthriticus verus. Hoffm.
Arthritis, podagra. Parr.
Podagra, arthritis. Young.
Nikris. Jir. Pers. Turk.
Goutte. F.
Zipperlein. G.
Gout.

« Regularis. The articular pain, swelling, and inflam-
mation considerable ; continuing for several days,
often with remissions and exacerbations ; then gra-
dually dispersing, and leaving the constitution in its
usual or improved health.
Podagra regularis. Cull. Macbr.
Regular Jit of Gout.
C Larvata. Disguised and lurking in the constitution,
and producing derangement in the digestive or
other functions, with only slight and fugitive aflec-
tion of the joints.
Podagra atonica. Cull.

3. Podagra regularis. Said to be produced by easing acid cher-
ries. Lentiluc. Miscell. ii. 358. Epk. jYat. Cur. Dec. iii. ann. iii.
obs. 45. Said on the contrary in the case of Linneus to have been
cured by his eating strawberries ; and this in five successive parox-
ysms recurring annually, each being slighter than the other ; till by

1 -»6 NOSOLOGY. [CL. III.-OR. lU

Podagra irregularis. Machr.
Disguised; lurking; atonic Gout.
y Complicata. The disease fixing on some internal or-
gan instead of on the joints ; or suddenly transferred
from the joints after having fixed there ; producing,
in the internal organ afl;ected, debility or inflamma-
tion according to the state of the constitution.
Podagra complicata. Machr.
Podagra retrograda. P. aberrans. Cull.
Retrograde ; rccedent ; misplaced Gout.
4 HYDARTHRUs. Tcnsc, permanent, colourless swelling, chief-
ly of the larger joints; inflammation slow,
-V,- and deep-seated ; pain severe and fixt :

*■•. . imperfectly suppurative : fever a hectic.

•Hydarthrus. Sauv. Cull.
Arthritis hydarthrus. Parr. Art. Nosol.
Emmyxium articulare. Young.
Tumor albus. Plouquct.
Tumeur blanche. F.
Wciss-schwellen. G.
White- sw e. lling.

» Plethoricus. Pain diffused; swelling considerabTe
from the first ; originating and chiefly seated in the
cartilages and ligaments of the aflfected joint ; found
principally in plethoric habits.
Rhiumaiic While szvellins:. Bell on Ulcers.
fc Strumatosus. Pain circumscribed and shooting from
a point ; swelling from a general thickening of the
part ; at first inconsiderable; originating and chiefly
seated in the bone. Found principally in scrophu-
lous habits.

a perseverance in the same fruit, the disease at length did not show
itself for nearly twenty years. The story is told agreeably by M.
Hedin, in the Amainitates Acadernicae for 1772, vol. viii. ; yet, ac-
cording to the general statement of his friends, Linueus's recovery
from the first and severest attack was rather owing to the exhilara-
tion of his spirits, by the return of his pupil Kalm, with a large col-
lection of rare and undescribed plants from America, than to the
use of the stawberrv. Maton's Edit, of Pulteney's Life of Linncus,
p. 103.

This supposed effect of the Iragaria vesca on Linneus has been
often treated with pleasantry. But if it be true that on some con-
.stitutioiis it has occasionally acted as a poison, as is asserted in the
work first (juoted, there is no reason why it may not have, an effect
equally salutary on others.

CL. IlI.-OR. III.] NOSOLOGY. ^ 157

Scrophulous White swelling. Bell,

" I conceive all such collections of matter to be of
a scrofulous nature : they are most common in the
young subject, and seldom found in the full-grown or
old. The suppuration is not proper puf, nor the swelling
proper injiammation.^'' Hunter on Blood, p. 391.

ORDER III.

EXANTHEMATICA.

ERUPTIVE FEVERS.

CUTANEOUS ERUPTIONS ESSENTIALLY ACCOMPANIED WITH FEVERc.

The term exanthemata among the Greeks imported cutaneous
efflorescences or eruptions gen«ra//i/. It has since been limit-

Order III. ExANTHEMATicA. From i^emkoy " effloresco," " per
summa erumpo.'' it is in the last of the above significations that
exanthema has been employed by Dr. Willan, in his valuable and
well-known work on Cutaneous Diseases, who uses it as merely syno-
nymous with Rash, and defines it an eruption " of red patches on the
skin, variously figured, in general confluent, and diffused irregularly
over the body, leaving interstices of a natural colour. Portions of
the cuticle, he continues, are often elevated in rash so as to give
the sensation of an uneven surface. The eruption is usually ac-
companied with disorder of the constitution, and terminates in a few
days by cuticular exfoliations "

This, so far as the writer of these pages is acquainted, is alto-
gether a new definition of the term : it applies admirably to the
English rash, but why rash and exanthema should be regarded as
strictly parallel and synonymous, and equally limited in their mean-
ing, seems not a little difficult to determine. Dr. Willan admits the
term to have been used upon a much broader scale by the Greek
physicians, whom he has quoted against himself, while he does
not always continue strictly true to his own views : for after
having, in his table of definitions, characterised rash or exan-
thera as distinct from papula and wheal, he employs it as the name
of an order embracing diseases distinguished by both these appear-
ances. Exanthema, till the publication of his work, however ex-
plained in other respects, had uniformly been regarded as indicative
of a class, order, or family of diseases, of which rash, red cutaneous
irregular patches, constituted a single division. If rash, as suspect-

158 NOSOLOGY. [CL. IIl.-OR. III.

ed to express cutaneous eruptions, accompanied roith fever,
a boundary assigned to it by Sauvages, Linneus, Vogel,

ed by Dr Johnson, be a corniption of rush^ it may possibly, on its
first use, have been employed coordinntely with exanthema in the
general sense of eruption ; but we have no knowledge that it was
ever so employed ; while its derivation, as thus traced, however in-
genious and probable, is altogether a matter of conjecture. As far
back as we can follow up the use of the term by medical wfiters,
rash has uniformly imported a particular species of eruption, while
exanthema has, at least for centuries, perhaps always, expressed
eruptions in general, or at least eruptions in general accompanied
with fever.

Dr. Parr, in the article of his Dictionary, Cutanei Morbi^ ap^
groves so highly of Dr WiPan's arrangement and definitions, as to
bestow much pain- in correriing what he bflieves to form its only
irnperfection, narrely, cn' »vant of a classific division of the pyrec-
tic and the apyrectic affections. Yet with that singular versatility
of opinion which, in the midst of great merit and ingenuity, so fre-
quently marks the progress of his work, he abandons, in his article
JVosology, both Dr Wiilan and his own improvement of Dr Willan ;
relinquishes Dr. Willan's definitions, and in many instances his ar-
rangement; and once more employs exanthema in the general sense
of eruptive fevers, both specifically contagious and the contrary.

In this common sense of the term it is adopted in the present
system. Dr. Cullen in his note on Exanthemata, thinks It worth
considering whether the word should not be limited to eruptions
(he does not say fevers) produced alone by specific contagion :
" erupliones a contagione specifica ortae." " In which case," conti-
nues he, " eruptions destitute of such contagion, and depending on a
particular state of fever alone, certainly cannot be ranked among
the g. nuine exanthemata." He has hence omitted petechia (petec-
chia, as it should be spelt, if retained at all,) and doubts whether he
ought not to have omitted miliaria and aphtha. " Again," says he,
" since the exanthemata are, for the most part, contagious, and oc-
cur only once in the course of a man's life, it seems perfectly fitting
that these should be distinguished from the uncontagious eruptions
which occur, or may occur repeatedly within the same term of
time : and hence there is but little reason for arranging variola and
erysipelas in the same order. And since, moreover, the eruptions of
certain diseases are not always of an identic form, nor always make
their appearance, and especially on the same day of the disease, it
may be well doubted whether diseases of this sort should be ranked
among the exanthemata; and lam hence undecided whether pestis
should be carried to the order of exanthemata or of fevers."

There is, perhaps, somewhat too much nicety in these remarks,
and it is well that Dr. Cullen did not atten^pt to regulate himself by
them in his nosological arrangement, which, in consequence how-

CL. II1.-0R. III.] NOSOLOGY. 159

Sagar, Macbride, Cullen, and various others : and il has
still more lately been attempted to be fettered within a

ever, is at variance with his definition : for they would have com-
plete!)' taken him from that simplicity which is the characteristic
merit of his method, and involved him in inextricable perplexity.
If all diseases produced by specific contagion were eruptive, the
term exanthemata might be properly enough applied to, and limit-
ed by, them ; but as this is by no means the case, there is no more
ground for making specific contagion essential to exanthems, than for
making exanthems essential to specific contagion, the absurdity of
which last idea must be obvious to every one. In reality, fever, erup-
tion, and contagion, have no necessary or natural connexion with each
other. Each may exist separately, or in any mode of conjunction with
the rest; and an union of the two former, of fever and eruption, fe ,
sufl&cient to characterise an order which may be correctly distinguish'
ed by the name of exanthems, whether contagion be combined with
them' or not. Such combination, or the absence of it, might be a good
feature for a subdivision of the order, if it were necessary, but it is
not called for, in laying down the broad outline of an order itself. Pe-
tecchia, in Dr. Cullen's system, is proscribed with great propriety
from the list of exanthems ; not because such an affection is uncon-
tagious, but because it is a mere symptom of diseases of various
kinds, both febrile and infebrile ; a simple deposition of blood, from
vascular debility or a dissolved state of the sanguineous fluid, and
not a specific eruption of any sort.

There seems as little reason, in laying down the character of ex-
anthemata, for considering whether the diseases the term is intend-
ed to include occur once or more than once in the course of a man's
life. This is a part of physiology still considerably open to inquiry,
and in which we have hitherto made but little progress. We fre-
quently see in inflammations or simple cutaneous eruptions, that a
part which has undergone a particular action, as in the diff'erent
species of erythema, is no longer excitable by the virus that pro-
duced such action, and returns to a state of health, while the ad-
joining part, which has hitherto remained unattacked, is open to its
influence. We perceive the same common fact in a variety of dis-
eases that assault the system generally : and especially in the order
of eruptive fevers in whatever sense we use the term. When the
constitution has once submitted to their influence, a change has
been made in it which renders it, for a considerable period of time,
far less susceptive of such influence than antecedently; so that, up-
on an equal exposure to the morbid cause, fresh persons always be-
come more readily affected than the person who has lately recover-
ed from its operation. So long as this change or effect produced
upon the constitution continues, the disease is incapable of return-
ing, the system being insusceptive of its influence. But we know
little of the nature of this change, and not much of the term of
time to which it extends. We see evidently, however, that in some

160 NOSOLOGY. [CL. III.-OR. IIL

narroA/er circle, sometimes ])y confining it to eruptive fe-
vers produced by specific contagion^ whatever be the cha-

diseases the impression is more fixed, and the term of time more
3xtensive than in others. And hence, while recovery from the
plague emancipates for only a short period, recovery from the scar-
let fever emancipates for a much longer; and recovery from the
small-pox and measles for a term of time equal to the whole of life ;
so that, generally speaking, such diseases, as well as numerous
<)thers that produce an impression of equal duration, are only under-
gone once in the course of a man's existence.

Such is the variation of power evinced by different diseases : and
we see a similar variation evinced by different constitutions. Some
are naturally so little susceptible of a particular contagion as never
to be affected by it, though often or continually exposed to its in-
fluence ; others to be but slightly susceptible of it, and hence to
pass through the disease with comparative facility, even under un-
skilful treatment, or other unfavourable circumstances : while a
third kind, from a strong natural susceptibility, suffer severely even
under the most judicious advice and treatment. It is on this account
that some persons never have ihe small-pox, even when inoculated
for it, or directly exposed to its atmosphere ; that others have a crop
of not more than ten or twenty pustules with little fever, during
the natural disease ; and that others again are seamed and scarred
with it from head to foot. And hence the reason why this and se-
■veral other diseases, that commonly aever occur oftener than once
in the course of a man's life, are occasionally traced twice or even
three times in the same individual. For the more rooted the natur-
al propensity to a disease, the less durable the change and immuni-
ty purchased by a single attack, and the sooner the system returns
to its natural susceptibility and predisposition. On which account
we shall perhaps find, without a single exception, that wherever
the small-pox has occurred a second time, it has been in persons who
Jbave had it with great severity in the first instance.

There are some fevers, again, and perhaps the greater number,
:that produce no change of any kind upon the constitution in regard
to general susceptibility, leaving it in this respect precisely as they
found it. While there are others, again, that, by a single attack,
introduce a habit of repetition, and thus render it more instead of
less susceptive of the same complaint, and oj)en to the same influ-
ence : a remark which particularly applies lo intermitting fevers,
or those produced by marsh-miasm; to which the oftener a patient
has been a victim, the more deeply, and especially on a recurrence
of the same season or other circumstances, he is predisposed to their
i?sault«again.

This is perhaps the whole we are acquainted with in regard
to tlu! general law of morbid recurrence. VVe behold a striking
.VifTf'rence both in different diseases and in their influence upon dil-

CL. IIl.-OR. III.] NOSOLOGY. IGl

racter of the efflorescence : and sometimes by restraining
it to the character of the efflorescence alone, with little at-
tention to its being connected or unconnected with fever.

ferent constitutions ; but we know nothing of the cause of this dif-
ference in either case. And whilst, therefore, such differences con-
tinue, and more especially whilst we are thus ignorant of their
causes, it seems altogether superfluous, and would perhaps be in-
correct, to limit the definition of exanthemata by a character which,
in a considerable degree, eludes all inquiry, and which is perpetu-
ally shifting its form both in different and even in the same species
of diseases, as influenced by different idiosyncrasies.

In the ordinal deiinition of oxanthematica, therefore, the author
has found it necessary to deviate from Dr. CuUen, as he himself
has deviated from it in the list of his genera; and to fall back upon
the wider latitude of Sauvages, Linneus, and Sagar. In Cullen, the
ordinal character runs thus : " Morbi conlagiosi ; semel tantum in de-
cursu vitJE ahquem afficientes ; cum febre incipientes ; definito tempo-
re apparent phlogoses, saepe plures, exiguae, per cutem sparse :"
while the order itself is made up of diseases, to some of which the
first feature does not apply, to others the second, to others the third ;
and to many of them several of these features collectively. The
definition of Sauvages is as follows : " Eruptiones cutaneae cum py-
rexia, saepius maligna, quandoque lenta :" of this the first half is
alone sufficient ; the second being superfluous, and perhaps incor-
rect. On this account the character of Linneus is an improvement,
" Febris cum efflorescentia cutis maculata," Here macutata might
conveniently be omitted ; it is not wanted, and the feature is some-
times not found, as in those cases of scarlet fever in which the red-
ness constitutes a diffused and universal flush. Sagar, however, has
copied itjVvith a very unnecessary addition of other symptoms, some of
which do not always exist, and the whole of them never collective-
ly ; " febris cum efflorescentia cutis varia, maculosa, pustulosa,
phlyctcenoidea et asthenia."

The author will only add, that under the Linnean school there
appears to have be^n a strong and general tendency to ascribe all
kinds of contagion, whether febrile or unfebrile, and indeed a mul-
titude of other disorders, to an animalcular origin : a tendency de-
rived partly from the opinions of earher writers, and partly from
the remarks of contemporaries. One of the fullest articles upon this
subject occurs in the Amcenitates Academiccc, Vol. V. from the pen of M.
J. C. Nyander, to which, as well as to the general subject it embraces,
the author has already adverted in the note on Helminthia, Class 1.
Ord. II. The reader, who is desirous of unfolding this theory further,
may consult Plenciz, and particularly the preface to his works, and
the second volume of Schaeffer's Versuche. But this is to take too
narrow a view of the subject, as well as an erroneous one. With-
out inquiring how far contagious miasms may be possessed of Titali-

162 XOSbLOGY. [CL. ni.-OR. III.

It is in the second and more popular of these significations
that ExANTHE?.iATicA IS employed as the name for the pre-
sent order.

GENUS L
EiNANTHESlS.

Eruption of red, level, or nearly level patches ; variously

ty, we see abundant proofs that they are equally derived from an
animal, veg'etable, and chemical source ; or rather that they consist
chiefly of animal and vegetable elements decomposed by putrefac-
tion, or other cause of disintegration, and chemically recombined in
a new and active mode ; obtaining by such recombination a power
of producing disease in some instances by contact, or close approxi-
mation ; in others by infection, or through the medium of the at-
mosphere.

Gen. I. Enanthesis. From gv, in, intra, and utSiu^Jloreo ; "efflo-
rescence from internal affection:" and hence opposed to exanthesis,
(e|«i»^>jo-<?,) which in the present system constitutes a genus under
Class VI. Ord. III., and comprises such efflorescences as are merely
superficial or cutaneous, and not necessarily connected with inter-
nal or constitutional affection. Enanthesis is here therefore used to
express fever accompanied with rash ; the word rash being employ-
ed in the broader sense in which it is adopted by Dr. VVillan, in his
third order, compared with the explanation given in his fifth defini-
tion ; as importing red, irregular, confluent patches, whether sim-
ple, as in the case of scarlet fever, or compounded of papulae or of
wheals, as in the case of measles and nettle-rash.

This arrangement reduces the genera of Sauvages and Cullen io
species, and their species to varieties. In Mafbride they are al-
ready reduced in the same manner, as are the species in Willan .-
who, indeed, continues the term genera, but incorrectly, as the link
of species is vvanting in his method ; and who for the most part ex-
pressly calls tliese subdivisions, varieties.

1. Enanthesis Rosalia. Sauvages and Cullen, who has copied
Sauvages's definition, represent the efflorescence as not appearing till
the fourth day after the attack : Dr Willan, more correctly as it
has corresponded with the author's own practice, aftirms that it ap-
pears ""usnally on the second day."

Tlie small-pox, measles, and scarlet-fever, seem equally to have
been derived from the east; and for the earliest descriptions ot
them we must turn to the writers of the Saracenic schools, particu-
larly those of Cordova. It is singular. how«ver, that as the mea-

GE. I.]

NOSOLOGY. 163

figured ; irregularly diffused ; often confluent ; terminating
in cuticular exfoliations.
Rash Exanthem.
J. ROSALIA. Rash a scarlet flush, appearing about the second
day on the face, neck, or fauces; progressively
spreading over the body ; and terminating about
the seventh day : fever a typhus.

sles were for a long period confounded with the small-pox, so the
scarlet-fever was, for an equal length of time, confounded with the
measles: and hence it is difficult in one instance, to determine what
is the precise variety of disease referred to hy Avicen^a, Haly Ab-
bas, and Rhazes : all seem occasionally to allude to the scariet-fe-
ver, but we are not sure that they mean it.

It is on this account that the earliest names for these diseases are of
Saracenic, or rather of Cordovan origin, as variola, rubeola^ or rather
rubiola, and rosalia. Of these the first is derived, not as is usually
and most absurdly supposed, from the Latin varius, but either from
the old Spanish vario, " a pock or pimple," or from the Spanish di-
minutive viruelas, importing small-pos at the present moment, and
evidently derived from the Latin virus, first latinized into viriiola,
and afterwards changed or corrupted to variola ; in Italian vajuolo
in which the ^l is retained ; as though virus was the radix. The
second term is a direct diminutive from the Spanish riibio, " red, or
ruddy ;" and was originally written and pronounced rubiola, though
long since changed to rubeola, as more consistent witii the Latin.
The third is, in like manner, a Spanish diminutive from rosul, the
rose-tree, so denominated from the colour of the efflorescence. This
term in the south-east of Italy was soon aft rwards exchanged for
rossalia, from rosso, ''red or blushful;" and appears still later, pro-
bably in order more accurately to distinguish the peculiar tint of
the red, to have yielded to scarlatina, '' scarlet-rash or scarlet
fever." While as the two diseases of measles and scarlet fever, as
just observed, were for a long time confounded with each other,
rosalia, rossalia, and rubeola, were used indiscriminately for both.
Morbilli or morbillo, in like manner a Spanish diminutiv.e, has per-
haps been the more common name by which measles have been
distinguished till within the last half century ; and hence this, also,
has been equally applied to scarlet fever, and down to as late a pe-
riod ; for, even in our own country, we not only find the two dis-
eases, in many of its varieties, united by Morton, but by Sir WiUiam
Watson. So rougeole, which, among the French writers, is the com-
mon name for measles, imported also at one time scarlet fever ;
and this so generally, that when physicians became at length sensi-
ble of the difference between the two maladies, and it was necessa-
ry to establish distinct terms, we learn from Cheveneau, that among-
the Marseillois rougeole was at first appropriated to the scarlet fever,
while the measles were denominated senepion. " Vulgus Massilise

^64 NosoLOGr. [cL. m.-oR. iir.

Rosalia. Auct. Hisp.

Rossalia. Ingrass et Auct. Neapol.

Purpura. Schulz. Junck.

Scarlatina. Auct. Ital. et Angl.

Typhus scarlatinus. Cricht.

Febris rubra. Heberd. Comment.

Scharlachaufschlag. G.

Fievre rouge. Fievre scarlatine. F.

Scarlet fever.

May possibly be alluded to by Avicenna, as suggest
ed by Dr. Willan under the name of Alhemake, but the
description is too short, and at the same time too loose
to determine. Hemak is applied by the Arabic wri-
ters to red efflorescences generally, whether papular
or pustular ; and is hence rendered by Meninski, from
Wankulus, '' varioli, vel exanthemata iis similia. He-
mak, in gardening, signifies the beet-plant (beta vulgaris,)
in physiology, mental derangement ; and the term may,
in the present instance, have been used by Avicenna, on
account of the colour of the eruption, or the violence of
the attack, as producing delirium.

distinguit rubiolam a morbilHs; hos vocantes senepion et illatn rouge-
ole, in qna non sunt pustulac, sed magnae tantura areae, in modum
erysipelatis rubentes." Obs. Med. p. 454.

It is said by some that scarlatina was first employed by English
writers as a name for scarlet fever: but this can only mean that it
was first employed technically or generically ; for the ivord, which
is an Italian diminutive, reached us, like injluenza, from the Levant^
where it was in vulgar use as a synonym of rosalia and rossaha long
before it found its way into English nosology. It is a term, howev-
er, so barbarous and unallied to both Greek and Latin, as well in
its origin as in its termination, that no good writer of any country
has ever been able to tolerate it; and it is matter of no small won-
der that it should hitherto never have given way to the original
name of rosalia, of genuine Latin derivation, and with a more clas-
sic close.

Morton had so mortal an aversion to the term, that he perferTed
the error of blending scarlet fever with measles, and of arranging
the varieties of the two diseases under the common generic name
of morbilli, to employing scarlatina. De llaen appears to have
had nearly as great a dislike to it : " Nomina morbi," says he, " va-
via, crronea saepe, ineptaque, quibus cum raedici quondam appella-
runt, laudatis in scriptoribus invenirc est, Scarlatince nomine, barba-
ro satis, a colore panni vulgo sic appellati, mutuato, civitateque, ut
videtur, in arte donate." Jilcd. Contin. torn. i. cap. vii. Br. Hux-
ham for a long time eluded the term by using febris miliaris rubra,,

m.

OE. I.] NOSOLOGY. 165

te. Simplex., Fever moderate, and terminating with the
rash : little prostration of strength ; slightly contagious.
Scarlatina simplex. Cull. Willan.
Scarlatina febris. Sauv, Sydenh.
Scarlatina benigna. Macbr.
C Paristhmitica. Fever severe ; throat ulcerated ; rash
later in its appearance and less extensive; often chang-
ing to a livid hue : highly contagious.
Scarlatina anginosa. Sauv. Withering. fVillan.
Scarlatina cjnanchica. Cull.
Scarlatina maligna. Macbr.

The s. maligna of Willan is perhaps the same variety
in its worst degree ; and is hence included in it by the
other nosologists quoted above.
2. RUBEOLA. Rash in crimson, stigmatised dots, grouped in ir-
regular circles or crescents ; appearing about
the fourth day, and terminating about the
seventh : preceded hy catarrh ; fever a cauma.
Rubeola. Auct. Hisp. Sauv. Sag. Cull.
Morbilli. Sydenh. Morton. Junck. Macbr.
Febris morbillosa. Hojfm.
Typhus morbillosus. Cricht.
Phoenicismus. Plouquet.

Hasbet. Avicenn. from (hasb) " erumpere." The
Turkish writers call it kyzamak, and the Persian sc-
rukje, literally rubor.
Kindsfiecken. G.
Rougeole. F.
Measles.

« Vulgaris. Rash slightly prominent, extending over
the mouth and fauces; harsh, dry cough ; inflamed,
watery eyes. Occurring once only in the course of
a man's life :-contagious.

or maligna, for some of the varieties of scarlet-fever, and feb7-is an-
ginosa miliaris for others ; and Dr. Heberden has still more lately
employed febris rubra. ' Willan continues scarlatina, but thinks it
necessary to apologize for its continuance. " The denomination
scarlatina," says he, " was first applied to this disease by British
writers : however offensive the term may be to a classical ear, it
cannot well be displaced, having fonnd admission into all the sys-
tems of nosology. Another age will correct and refine the lan-
guage now used in subjects untouched by the fathers of physic."
Whether that age have yet arrived remains to be proved ; but the
present work shall not be without an attempt, however feeble, to
hasten its appearance. And on this ground, and not from any love

166 NOSOLOjQty. [CL. III.-OR. IIU

Rubeola vulgaris. Sauv. Cull. Will.
Morbilli regulares. Sydenh.

See Rhazes ad Almans. torn. v. cap. 28.
C Spuria. The rash running its regular course with little
fever or catarrhal affection ; affording no certahi se-
curity against the common or regular disease.
Rubeola sine catarrho. Will.
y Nigra. The rash about the seventh or eighth day as-
suming suddenly a black or livid hue, interspersed
with yellow ; prolonged in its stay ; and accompanied
with increased languor and quickness of pulse.
Rubeola nigra. Willan.

"There is no sufficient ground or authority for the
distinction of rubeola variolodes made by Sauvages.''
Willan.
3. URTICARIA. Rash in florid, itching, nettle-sting wheals ; ap-
pearing about the second day ; irregularly
fading and reviving, or wandering front
part to part : fever a ruild epanetus.
Urticaria. Cull. Willan.
Uredo. Linn.
Scarlatina urticata. Sauv.
Febris urticata. Vog.
Purpura urticata. Jutick.

Benat-allil (Aruh.), literally " Offspring or daughters of
the night."

of change for the sake of cliangfe alone, the author ventures to re-
vive the more ancient and elegant name of rosalia at the expense
of a term which, though in common use, is in common disappro-
bation.

I.e. E, Rosalia Faristhmitica. The term paristhmitica is here
preferred to anginosa and cynanchica, for the reason that paristhmi-
tis is preferred to angina and cjnimche in the preceding order. Gen,
VII. Spec. 4. to the note on which the reader m;iy turn.

2. Enanthesis Rubeola. Origmally, as ah-eadj^ observed, written
ruhiola., a Spanish diminutive from i ubio, " red ;'' and afterwards
latmizpd to reheola, as though denved from " rubeo, rubeus, ruber."
See the note on llosaha.

2. y E. Rubeola Nigra. Cullen, probably from complaisance, has
copied rubeola variolodes into his list, but with a doubt of its cor-
rectness. It is singular, however, that he should add that this promi-
nent or papulated variety is called in Scotland " the nirles :" a term
which, according to Willan, is also applied both in Scotland and the

GE. II.]

NOSOLOGY.

167

Brennesselausschlag. G.

Fievre ortiee. De Meyztrey, Malad. des Arm.

Nettle-rash.

GENUS II.
EMPHLYSIS.

Eruption of vesicular pimples filled progressively with an
acrid and colourless, or nearly colourless fluid ; termi-
nating in scurf or laminated scabs.
Ichorous Exanthem.
1. MILIARIA, Vesicles scattered over the body ; of the size of
millet-seeds ; transparent red ; afterwards
milky : preceded by a pricking sensation,
sighing, anxiety, and sour sweat.
Miliaria. Linn. Cull.

border counties of England to herpes miliaris. See Will. Rubeol.
p. 238 : Perhaps rather to h. exedens.

Gen. II. Emvhlysis. From ^, pro, tv, " in, intra," and (pxvrti^ " a
vesicular tumour or eruption." EKipxvu is usually employed among
Greek writers nearly in the same sense as <pAt;6>; in the present
system it will be found employed somewhat more strictly, and in
opposition to i(x.(pxva ; so that, while emphlysis, from the latter,
imports an eruption of vesicles, whether large or small, produced
by, or accompanied with, internal and febrile affection essentially
connected with it; ecphlysis, from the former, imports an eruption
of vesicles simply cutaneous or superficial: or if, in a few varieties
combined with internal affection, not necessarily or essentially as-
sociated. See, for the use of ecphlysis, the note on CI VI. Ord. III.
1. Emphlysis Miliaria. This species, from the minuteness of its
vesicles, treads close upon the general complexion of the genus
enanthesis, and during its red appearance is often called a rash. By
Linneus and Parr (art. Nosol.) it is hence defined nearly in the same
terms as rubeola, so far as relates to the eruption ; and at Leipsic
in 1650, where it is said to have been contagious or epidemic, was
unquestionably mistaken for rosalia or scarlet fever. Schacher, de
Febre acuta exanthematica. Lips. 1723, in Haller. Disp. Med. torn.
V. sect. 175. Welsch, Hist. Med. in Hall. torn. v. sect. 174. It is not
often, however, communicable ; and in the present day is seldom
found in any form, except as a symptom of some other disease :

168 NOSOLOGY. [CL. III.-OR. III.

Miliaris. Sauv. Sag.

Febris miliaris. J^og. Webster.

Exanthema miliaria. Part-.

Synochus miliaria. Young.

Purpura. Hoffm. Allion. Tract.

Friselblattern. G.

Miliaire. Millot. F.

Miliary fever.

The two varieties, as they have been often called,

of m. rubra and m. alba, seem to be only different

stages of the disease. The vesicles are at first red

from the colour of their under surface or inflamed base.

being transmitted through the transparent pellicle ; they

are afterwards opake and milky from absorption of the

more attenuate part of the fluid or from some other

change.

Found, occasionally, as a symptom in fevers of dif-
ferent descriptions, both inflammatory and putrescent :

chiefly in typhus puerperarum.
2. APHTHA. Vesicles granular, roundish, peai'l-colouued ; con-
fined to the lips, month, and intestinal canal ;
terminating in curd-like sloughs ; occasionally
with successive crops.

Aphtha. Sauv. Linn. Sag. Boerh. Cull.

Febris aphthosa. Vog.

Pemphingodes. Gal. Finit. Med.

Pustulae oris. Haly Abbas.

Typhus aphthoideus. Young.

Mundschwamchen. G.

Aphthcs. F.

Thrush.

though the author has at this moment a clear and well-marked in-
stance of it, as an idiopathic afl'ection, in a young gentleman of thir-
teen years of age. 'I he vesicles are very numerous, though dis-
tinct: they were at first red, and are now milky white: the fever
has heen consirlei able. The disoase takes its name from rnilia.^
" millet-grains,'' from the resemblance of its vesicles to the seeds
of this plant in size, and, whfn matured, in colour. The eruption
appears at an uncertain period after the introductory fever has com-
menced. Darwin ii. i. 3. 12, mentions a variety of this disease
" produced by the warmth, and more particularly by the stimulus
of the points of the wool in flannel or blankets applied to the skin,
which by cool dress, and bed-clothes without flannel, has soon

<5E, II.] NOSOLOGY. 169

« Infantum. Appearing in infants soon after birth ; and
often extending from the mouth to the intestinal
canal ; mostly with slight febrile symptoms, and
white sloughs.
Aphtha infantum. Cull.
Aphtha lactucimen. Sauv.
White-Thrush. Sometimes contagious. See Raulin Von
Erkaltung der Kinder.
C Maligna. Accompanied with great debility of vascular
action ; usually ascending from the pharynx into the
mouth ; sloughs black ; fever a typhus.
Aphtha maligna. Sauv.
Black-Thrush.

Found frequently in old age ; and, as a symptom, in
low fevers and cachexies.
S. VACCINIA. Vesicles few or a single one ; confined to the
part affected ; circular, semitransparent, pearl-
coloured ; depressed in the middle ; surround-
ed with a red areola.
« Nativa. Vesicles on the hands, or such parts as have
been in contact with the affected udder of a cow ; of
a blueish tint; the fluid at first limpid; afterwards
opake, and purulent ; often with enlargement of the
axillary glands, and considerable fever.
Natural Cow-pox.

A prophylactic against the small-pox.
C Spuria. Vesicles less uniformly circular ; purulent
from the first ; without blueish tint ; with little or no
central depression.
Spurious Cow-pox. Jenner.

Affords no security against the small-pox.

ceased ;" to which he gives the name of miliaria sudatoria. It is
perhaps rather a variety of intertrigo.

2. Emphlysis Aphtha. ''A<p$Kt : from «5rT*i, " accendo." This erup-
tion, like the preceding, is now generally admitted to consist of
minute vesicles containing a whitish or milky fluid when matured.
Hence Sauvages describes the disease as " eruptio phlyctcenarum,
interiorem oris superficiem occupantium ;" adding, that like the
last species, the efflorescence bears a resemblance to millet-seeds
' — " elevatio epithelidis instar grani milii.'' In like manner Sagar :
" eognoscitur aphtha phlycthosnis linguae, faucium, oris superficium
occupantium." To which he adds, that in its third or mature stage,
*' elevantur papulae seu maculae in phlycthanas miliares, quce pro-
22

17® NOSOLOGY. [CL. lll.-OR. III.

y Inserta. Produced by inoculation ; vesicle single, con-
fined to the puncture ; cellulose ; blueish-brown in
the middle ; fluid clear and colourless to the last ;
concreting into a hard, dark-coloured scab after the
twelfth, day.
Variola vaccina. Jenner.
Vaccina. Willan, et Aut. Var,
Exanthema Vaccina. Parr.
Synocha Vaccini. Young,
Inoculated Cow-pox.
S Degener. Produced by inoculation ; vesicle amorphous,
or uncertain ; fluid often straw-coloured, or purulent;
areola absent, indistinct, or confused with the vesicle ;
scab formed prematurely.
Degenerate Cow-pox. Blane. " Evidence before the House
of Commons.''''

Affords little or no security against the small-pox.
4. VABiCELLAt Vesicles scattered over the body ; glabrous 5
transparent ; pea-sized ; in successive crops ;
pellicle thin ; about the third day from their
appearance, bursting at the tip, and concret-
ing into small puckered scabs, rarely leav-
ing a cicatrix.
Varicella. Cull. Plenck. Heherden.
Exanthema Varicella. Parr.
Synochus Varicella. Young.
Unachten kindspocken. G,
Verole volante. F.
Chicken- Pox.

tt Lentiformis. Irregularly circular ; flattened at the
lop ; fluid at first, whitish, afterwards straw-co-
loured.
Lenticular Chicken-pox. Willan.

hahiliter sunt ecedem cum miliaribus cutis ;" — " the papulae or specks
are raised into miliary vesicles, and are probably the same as in the
miliary eruption of the skin.'' These observations are sufficient to
indicate not only under what genus aphtha should be placed, but
its particular station in the arrangement of the specific series ; and
that it should immediately follow miliaria, with which, for reasons
already offered, the genus ought to open.

4. Emphlysis Varicella. Varicella, like variola, is of Spanish ori-
gin ; and derived from the Saracen writers of Cordova , variz^ a
superficial or cutaneous tumour, producing a? its diminutive, vari-

GE. H."] NOSOLOGY. 171

Common Chicken-pox.
C Coniformis. Vesicles acuminated : fluid pellucid
throughout.
Conoidal Chicken-pox. Willan.
Pemphigus variolodes. Frank.
Variola lymphatica. Sauv.
Hydrachnis. Cusson.
Verolette. F.
Ravaglio. Ital.
Swine-pox. Water-pox,
y Globularis. Vesicles globular and larger ; fluid at first
whey-coloured, afterwards yellowish.
Hives,

The varieties are sometimes intermixed ; and the
fluid in a few of them occasionally approaches to a
purulent appearance : whence in various instances
they have been mistaken for the small-pox.
5. PEMPHIGUS. Vesicles scattered over the body ; transparent ;
filbert-sized; with a red, inflamed edge, but
without surrounding blush or tumefaction;
on breaking, disposed to ulcerate : fluid pel-
lucid or slightly coloured : fever a typhus.
Pemphigus. Sauv, Sag. Cult. Macbr.
Morta. Linn.

Febris bullosa. Vog, Stlliger,
Typhus vesicularis. Young.
Blasenausschlag. G.
Fievre vesiculaire. F.
Vesicular fever. Bladdery fever.

« Vulgaris. Vesicles appearing on the second or third
day, occasionally not till the fifth or sixth ; in suc-
cessive crops ; often extending over the mouth and

zella^ easily latinized into varicella : the Latin radical of both being
perhaps varus^ or pimple.

5. Emphlysis Pemphigus. From Ti/^^il (pemphix) " flatus, bulla ;"
and hence inflation, bladder, bubble. The idea of flatulence, how-
ever, is seldom connected with this disease in modern mf;dicine,
though very generally in ancient. The term, in the sense in which
it is now generally understood, was perhaps first employed by
Sauvages ; and has since passed into common use. It is still doubted
by many whether pemphigus is entitled to be considered as a dis-
tinct and idiopathic disease ; and whether all its varieties and modi-
fications may not resolve themselves into certain peculiarities of

172 jvosoLOGY. [cL. in.-OR. in.

intestinal canal ; fluid, on bursting, yellowish ; some
of the vesicles livid, with a livid base.
Pemphigus major, Sauv.
Pemphigus vulgaris. Willan.
Febris vesicularis catarrhalis. Deliu
C Glandularis. Preceded by tumefaction of the neck
and throat: vesicles chiefly seated on the fauces
and conglobate glands ; occasionally producing ab-
scesses : highly contagious.
Pemphigus Helveticus. Sauv.
Pemphigus contagiosus. Willan.
y Infantum. Vesicles irregularly oblong, with livid
edge, and commonly flattened tops ; appearing
successively on different parts of the surface, in
infants a few days after birth : fluid ; on breaking,
purplish.
Pemphigus infantilis. IVillan.

Found also, occasionally, as a symptom in one o$

other of its varieties, in erysipelas, typhus, plague,

and other depressing fevers.

^. ERYSIPELAS. Vesication diffuse ; irregularly circumscribed ;

appearing on a particular part of the body,

chiefly the face, about the third day ; with

tumefaction and erythematic blush ; fever

usually accompanied with sleepiness, often

with delirium.

erysipelas, or pompholyx, the latter of which consists of similar
Tcsicles or bullae without fever, or mere symptoms of typhus or
plague. Dr. Cullen seems to have been of the last opinion at the
moment of drawing up his definition : but the fourth edition of his
synopsis contains a subjoined note which intimates that his opinion
was altered in consequence of his having seen a patient, shown
him by his excellent colleague F. Home, and who was labouring
under this disease as an idiopathic affection at the time. And when
to this instance we add the authority, not merely of the earlier
writers, Bontius, Seliger, and Langhans, but of Withers, Dickson,
Christie, Ring, and Braune (Uber den Pemphigus, Leips. 1795,) it
would be unpardonable not to allow it a distinct place in a general
system of nosology.

The varieties run parallel with those of Dr. Willan, though not
exactly taken from him.

6. Emphlysis Erysipelas. For the distinguishing characters of
erysipelas and erythema, see the note on Erythema. Sauvages has
made shingles (herpes Zoster) a species of erysipelas, which in his

GE. II.] NOSOLOGY. 173

Erysipelas. Sauv. Linn. Sag, CulL

Febris erysipelatosa. Sydenh, Macbr,

Febris erysipelacea. Hoffm. Vog,

Hemret {Arab.\ literally rubedo.

Rothlauf. G.

Erysipele. Feu de St. Antoine. F.

Erysipelas. St. Anthony''s Fire.

» Locale. Limited to a particular part ; the cuticle

raised into numerous aggregate distinct cells ; or

the cells running into one or more blebs or. large

blisters.
C Erraticum. Travelling in successive patches from

part to part ; the former patches declining as new

ones make their appearance.

GENUS IIL

EMPYESIS.

Eruption of phlegmonous pimples; gradually filling with a
purulent fluid ; and terminating in thick scabs, frequent-^
ly leaving pits or scars.
Pustulous Exanthem.

nosology is a genus ; and Dr. CuUen has followed his steps. This
is erroneous : shingles is a mere variety of herpes, a cutaneous a^f-
fection, unaccompanied with fever as a necessary symptom, and
consequently not an exanthem. Its proper place is in Class VI.
Order HI.

The grammarians have usually derived igi;«wfA«5 from tgva^ " to
attract," and {riAas, " vicinity." " The neighbouring parts," says
Dr. Turton, in his useful Glossary, " being aflfected by this erup-
tion." The author cannot avoid thinking that the name is derived
from the colour ; and that i^tuStg^ rubor, whence i^wsriCjj, rubigo, is
the radical of the first part of the compound term rather than t^vu.
Egt;«-«tA»s, thus derived, will import, not an " attraction of redness,"
but a " neighbourhood of redness," which is the most prominent
feature of the disease.

Gen. III. Empyesis. E^wDortg, "suppuratio,'' Hippocr. Aph. 1. v.
from ifijrveu, o^£^Jr«8<u, " suppuro." The Greek writers also use,
and perhaps more generally, ecpyesis (eK?rii>i«5,) from uvvm, of
similar meaning. The same distinction between the terms is made

174 NOSOLOGY. [CL. ffl.-OR. III.

1. VARIOLA. Pustules appearing from the third to the fifth day
— suppurating from the eighth to the tenth ;
fever a cauma : contagious.
Variola. Haly Abbas, et Auct, J^eoter,
Euphlogia. Rhazes,
Jedrie. Arab,
Kindspocken. G,
Petite verole. F,
Small-pox,

K Discreta. Pustules pea-sized ; distinct, distended,
circular ; the intervening spaces red ; the fever
ceasing when the eruption is complete.
Variola discreta. Cull.
Variola discreta benigna. Sauv.
Variolae regulares discrete. Sydenh.

in the present case as between eraphlysis and ecphlysis : the former
being limited to signify pustular eruptions produced by internal and
febrile affection, and the latter to signify those that are merely
cutaneous or superficial, or with which internal affection is not necessa-
rily associated.

1. Empyesis Variola. The definition of this disease in Linn^us,
Sauvages, and most of the earlier nosologists, contains an inelegant
pleonasm from the very loose sense which was formerly attached
to the word pustula. A pustule is, strictly speaking, a cuticular
elevation or utricle containing a small collection of pus : but the
term has, by most of the earlier nosologists, been applied indis-
criminately to cuticular utricles that contain a fluid of any kind,
whether opake or transparent, purulent or ichorous, broken, or
having a tendency to break at their tip ; in the definitive explana-
tion of Sauvages, I. p. 96, " phyma parvulum apice ruptum." la
like manner, in the present day, we are constantly meeting with
medical writers of high and deserved character, who, still applying
to the word the same indeterminate idea, use the phrase vaccine
pustule for that of vaccine lymph, ichor, or, if its transparent cuticle
be imported, vesicle. It is hence Linn^us defines variola to con-
sist of "■ pustulae suppurantes, escharoticae, &c." Sauvages calls it
" genus phlegmatiae exanthematicae cujus eruptio in ptistulis phleg-
monodeis, ad suppurationem tendentibus, consistit ;" while Sagar
copies the very words of Linneus as a part of his fuller description.
—Among the Romans, pustula was used in a still wider and more
indeterminate sense, for Celsus applies it to rashes, to wheals, to
vari or solid pimples, to phlyctaense or vesicular pimples, and to
almost every kind of eruption or cutaneous elevation of whatever
nature or colour. Sec lib. v. cap. xxviii. § 15. And hence pustula

GE. ni.] NOSOLOGY. 175

Distinct Small-pox,
C Confluens. Pustules confluent, flaccid, irregularly
circumscribed ; the intervening spaces pale ; with
great debility.

Variola confluens. Cull. Sauv,

Variolse regulares confluentes. Sydmh,

Confluent Small-pox,
y Inserta. Produced by inoculation ; orange-coloured
areola about the puncture ; pain in the axilla about
the seventh day ; disease for the most part mild;
and the purulent discharge sometimes confined to
the punctured part.

Inoculated Small-pox,
i Degener. Pimples imperfectly suppurating ; icho-
rous or horny, and semi-transparent.

is, by Sauvages and Vogel, equally employed in their definitions of
variola and miharia, and by the latter in that of varicella.

For the origin of the term Variola, see the note on Rosalia.

It was the opinion of Mr. J. Hunter, that when variolous matter
is inserted into a weund, as in the case of inoculation, all that it
does is to stimulate the surrounding parts ta secrete a fluid similar
to itself, which being absorbed, infects the constitution : — so that
the patient really receives the disease from variolous matter gene-
rated in his own body. In consequence of which, while he allows
the inflammatory action hereby produced to be specific, he doubts
whether it be critical, and extends the same doubt to the inflamma-
tions that take place in the chicken-pox and measles. On Blood, p.
257. This reasoning, however, will scarcely apply to cases of
natural small-pox ; for it is here impossible to point out any one
organ in which the inhaled contagion is lodged, and stimulates to
suppuration, before the general fever makes its appearance. And
hence Mr. Cruikshank, who quotes Mr. Hunter's opinion apparent-
ly with approbation, feels compelled soon afterwards to fall back
into the more vulgar belief that the inoculating matter of small-pox
continues dormant for many days in the part affected, and is then
absorbed ; instejid of mstantly commencing a local stimulus, and
afterwards propagating its own kind. '' The matter of the inoculat-
ed small-pox seems to lie in the pustula till the seventh day ; after
which, the glands in the axilla swell (ifee mark of absorption,) and by
the time the matter may be supposed to reach the heart, the erup-
tive fever commences." Anat. of Absorb. Vess. p. 120, 125.

For an account of the high antiquity and practice of inoculation
in India, see Mr. Shoolbred's Dissertation " On Vaccine Inocula-
tion," p. 69, and following.

176 NOSOLOGY. [CL. III.-OR. III.

Variola discreta siliquosa. Mead, " Discourse of the

Small-Pox."
Variola confluens crystallina. Sauv,
Horn-pock. Crystalline-pock.

GENUS IV.
ANTHRACIA.

Eruption of tumours imperfectly suppurating, with indurated

Gen. IV. Anthracia. There have long been, and still continue
to be, great disputes among the nosologists as to the proper station
of both the species the author has ventured to arrange under this
generic term ; many contending that plague ought not to be regard-
ed as an exanthem, and most writers having hitherto contemplated
yaws as an impetigo, or some other djsthectic affection. Dr. Cul-
len, as already observed in the note on Exanthematica, expresses a
doubt whether the first should not be removed from the order of
exanthems into that of fevers : Vogel has introduced it into this
order; Willan has rejected it: Parr arranges it as. an exanthem in
his article JVosology, having previously, like Willan, rejected it from
that division in his article Cutanei Morbi. In his remarks subjoin-
ed to the article Nosology, he again acknowledges that " on re-
flexion it appears improper" to introduce it into the list of exan-
thems : and in his article Pestis, he asserts more roundly, that
" there is no foundation for arranging plague amongst the exan-
themata, and [that] it should be reduced to the asthenic remittents.^*
Sauvages, Linneus, Sagar, and Macbride, have entered it in the
order in which it stands in the present work.

In few words there appears strong and almost incontrovertible
reason for thus placing it. The fever is specific, like that of all the
exanthems ; it is contagious, like that of most of them ; and although
capable of occurring oftener than once in a man's Ike, we have the
concurrent testimony of all the writers who have been eye-witnes-
ses of its effects, that it renders him less susceptible for a considera-
ble period afterwards. The eruption of buboes or carbuncles is
unquestionably a pathognomic symptom : the fluid they secrete is
capable of producing the disease by inoculation ; for the most
part the earlier they make their appearance the better ; and it is
the opinion of M. Sotira, and of most of the French medical staff
appointed to the Egyptian expedition, that, provided the bubo freely
suppurates, the patient receives an indemnity for life. It is true,

GE. IV.] NOSOLOGY. 1/7

edges, and for the most part a sordid and sanious core.
Carbuncular Exanthem.

indeed, that these tumours do not always appear in their proper or
perfect character ; for sometimes the patient is destroyed by the
violence of the first symptoms ; and in other instances, as in small-
pox, the specific fever passes through its course with an imperfect
or trivial fructification ; but unless there be an actual germination,
or what Sauvages calls a coiiatus, a perfect or an imperfect epan-
thesis, we have no right whatever to call the disease a plague, and
can only regard it as a species or variety of synochus, or typhus.

The buboes or carbuncles, jimmerat^ are sometimes formed with
the first shock, or m'drop, as the Arabians call it ; and, in this case,
with a feeling of being pierced with a sharp needle, javelin, or
musket ball (tor it is differently described) in the affected thigh or
arm; the tumour appearing within a few hours, and enlarging, with
excruciating pain for three or four days, till it often acquires, before
breaking, the size of a small orange. Camphor, smoking tobacco,
fumigation with gum sandrac, and the vinegar of the four thieves
are chiefly employed as preventives; and the principal remedies in
the present day appear to be sudorifics at the commencement of
the disease, and the bark in liberal doses shortly afterwards. A
very favourite remedy in Egypt, at Constantinople, and Mogodore,
is a general inunction of the body with zeit jagghy, or oil of olives,
which appears to have been first recommended by Mr. Baldwin of
Cairo, from his observing that while the plague was ravaging all
Egypt, the dealers in oil escaped its attack. The coarser and more
acrid the oil the better. The application should be accompanied
with a long continued friction, and, when successful, is followed in
about half an hour or an hour by a general and profuse perspira-
tion which affords relief The oil obstructs the pores of the skin,
and prevents the escape of the caloric, which, aided by the friction,
accumulates on the surface, and shortens or altogether prevents the
shivering fit, which is otherwise often very severe. Probably the
use of volatile liniment, and especially combined with laudanum,
might be more serviceable. During the fatal plague which de-
populated the whole of Western Barbary in J 799, the emperor
Sidi Soloman is said to have had the disease twice, and is both cases
to have derived his cure from a free use of the bark ; in conse-
quence of which he is never without a large supply of it.

The Barbary plague of 1799 and 1800 is one of the severest on
record. Mr. Jackson, to whom we are indebted for an " Account;
of the Empire of Marocco,-' was an eye-witness to its progress;
and as he has described it with considerable detail, and a variety of
individual cases, the author will enrich this note by a few of the
more interesting facts which he has communicated.

"The symptoms of this phigue varied in different patients: the

^^^ NOSOLOGY. [CL. III.-OR. III.

1. PESTis. Tumours bubonous, carbunculate or both ; appear-
ing at an uncertain time of the disease : fever a
malignant typhus, with extreme heat and debili-
ty; contagious.

Loemus, {Aoifieg.) Thucyd. tt Auct. Grcec,

Pestis. Auct. Lett, et Neoter.

Pestilentia. Schrelber.

Febris Pestilens. Hoffni.

Typhus Pestis. Young.

Exanthema Pestis. Parr. Art. Nosol.

Vebau {Arah.\ vulgarly Alamer, " the mandate, decree,
or fate."

Pest. G.

Peste. F.

variety of age and constitujjon gave it a like variety of appearance
and character. In some it manifested itself by a sudden and violent
shivering, in others by a sudden delirium, succeeded by great and
unquenchable thirst. Cold water was eagerly resorted to by the
unwary and imprudent, and proved fatal to those who indulged in
its momentary relief. Some had one, two, or more buboes, which
formed themselves, and became often as large as a walnut in the
course of a day; others had a similar number of carbuncles ; others
had both buboes and carbuncles, which generally appeared in the
groin, under the arm, or near the breast. Those who were affect-
ed with a shivering, having no bubo, carbuncle, spots (^vibices,) or
any other disfiguration, were invariably carried off in less than
twenty-four hours ; and the body of the deceased became quickly
putrified, so that it was indispensably necessary to bury it in a i'ew
hours after dissolution. The European merchants shut themselves
up in their respective houses, as is the practice in the Levant : I did
not take this precaution, but occasionally rode out to take exercise
on horseback. My daily observations convinced me that the epidemy
was not caught by approach, unless that approach was accompanied
hy au inhaling of the breath, or by touching the infected person."

Yet the general atmosphere appears to have had an influence
over fresh persons; for we are told that "families which had retir-
ed to the country to avoid the infection, on returning to town, when
all infection had apparently ceased, were generally attacked and
died."' And what is more singular, persons who had escaped after
having resided in one infected town, were still subject to the
atmospheric influence of another infected town, " After the mor-
tality had subsided at Mogodore, a corps of troops arrived from the
city of Terodant, in the province of Suse, where the plague h<id
been raging, and had subsided : these troops, after remaining three
days at Mogodore, were attacked with the disease, and it raged ex-

GE. IV.] NOSOLOGY. i 70

Plague.

«6 Fructifera. The disease exlending to about the four-
teenth day ^ and relieved by the appearance of the
eruption.
Pestis vulgaris. Sauv.
» Infructifera. The eruption imperfect or suppressed :
transferred to some internal organ : or superseded
externally by stigmata and vibices.
■Pestis interna. Sauv.
Pestis sporadica. Sydenh. Saiiv,
y Erythematica. The body covered over vvitii trails
of vesicular erythema, producing deep, sanious and
gangrenous ulcerations as it spreads, often to the
loss of one or more limbs.

clusively among them for about a month, though they were not con-
fined to any particular quarter, many of them having had apart-
ments in the houses of the inhabitants of the town."

As in the plague at Athens, " the mortality was so great that the
living, not havmg time to bury the dead, the bodies were deposited
or thrown together, into large holes, which, when nearly full, were
covered over with earth. Young, healthy, and robust persons,
with strong stamina, were for the most part attacked first, then
women and children, and lastly, thin, sickly, emaciated, and old
people.-' The depressing passions of fear and grief had also a
strong predisposing effect. The remedies were those already
described. A few suffered twice. Marocco lost a thousand upon
an average daily, when the infection was at its height ; Old and
New Fez from twelve to fifteen hundred ; Terodant about eight
hundred. The total loss sustained in these three cities and in
Mogodore were estimated at one hundred and twenty-four thousand,
five hundred souls.

See also Memoirs Medicales de FArmee de I'Orient par Bruant :
Mem. sur I'Egypte, torn. iv. iSamoilowitz sur la Peste en Russie,
1771. Assalini's Observations, &c. ; and compare with IValdschmich
T)e Peste Holsatica, apud Halleri Diss, pract. torn. v. Unterricht
vors Volk gegen die Pest. Dantzig, 1770. Prosper. Alpin. de Med.
^.gypt, lib. i. M'Gregor's " Medical Sketches," written during the
passage of the English army from India to Egypt. The views of
this last writer are in direct opposition to those of M. Assalini, and
in many respects concur with those of Mr. Jackson.

1. y A. Pestis Erythematica. For the best description of this
variety of pestis we must turn to the pages of Thucydides, who
describes it from having been an eye-witness of its ravages, and a
sufferer under them ; or to those of Lucretius, who has copied the
account with close and technical punctuality. The following passage

ItiO NOSOSOGY. [CL. III.-OR. HI-

Pestis Atheniensis. Thucyd. Lucret.
Erysipelas pestilens. Sauv.
Erysipelas gane;raenosuin. Will.

Ignis sacer. ^uct. Var, but erroneously : this, which
is the erythema vesiculare, being only a symptom.
See Erythema vesiculare,
Mai des ardens. F.

See TissoCs account and all the authorities compared,
in his letter to Sir George Baker. Phil. Trans, vol. Iv.
year 1765; as also Mem, de la Societe, R, de Med. 1776.
Tissot ascribes it, in many extensive epidemics, to the
use of rye vitiated by a fungus somewhat of the nature
. of ustilago, or black mildew: called by the French er-
-' I S°^i whence this disease, as also a peculiar gangrene, to
. which it is likewise, under other circumstances, said to
give rise, is called Ergot by the French. Tissot de-
scribes both. See also Sauv. CI. III. Erysipelas pesii-
lens.

from the latter may serve to illustrate this remark, De Rer. JVat

lib. vi. 1152.

Spiritus ore foras tetrum volvebat odorem,
Rancida quo perolent projecta eadavera ritu :
Atque animi prorsum vires totius, et omne
Languebat corpus, leti jam limine in ipso:
Intolerabilibusque malis erat anxius angor
Adsidue comes, et gemitu conmixta querela :
Singultusque frequens noctem per saepe diemque,
Conripere adsidue nervo? et membra coactans,
Dissolvebat eos ; defessos ante tatigans.

Nee nimio quoiquJlm posses ardore tueri
Corporis in summo summam fervescere partem ;
Sed potius tepidum manibus proponere tactum,
Et simul, ulceribus quasi inustis, omne rubere,
Corpus, ut est, per membra sacer quern diditur ignis.
Intima pars hominum vero flagrabat ad ossa ;
Flagrabat storaacho flamma, ut fornacibus, intus :
Nihil adeo posses quoiquam leve tenueque membris
Vortere in utilitatem.

Forth pour'd the breath most fetid from the mouth.
As steams the putrid carcase ; every power
Fail'd through the soul, the body, and alike
Lay they liquescent at the gates of death :
While with these dread, insufferable ills,
A restless anguish join'd, companion close,
And sighs commixt with groans ; and hiccough deep.

GE. IV.] NOSOLOGY. 181

2. RUBULA. Tumours numerous and successive ; gradually in-
increasing from specks to the size of a raspber-
ry ; one at length growing larger than the rest:
core a fungous excrescence ; fever slight ; oc-
curring only once during life : contagious.
Lepra fungifera. Cartheusen.
Frambgesia. Sauv. Cull, Sag. Plouquet.
Schvvammformige aussatz. G.
Yaws.

a Guineensis. Attacking infants and young persons
chiefly ; and subsiding as soon as the eruption ap-
pears.
Frambaesia Guineensis. Sauv. Edinb. Essays, vol. vi.
Yaw. Guinea. , . •

Q Americana. Depascent ; and destroying progressive-
ly both muscles and bones; especially the master-
yaw, which is called mamanpia.
Frambaesia Americana. Sauv.

' And keen convulsive twitchings ceaseless urg'd,
Day after day, o'er every tortur'd limb,
The wearied wretch still wearying with assault.

Yet ne'er too hot the system couldst thou mark,
Outwards, but rather tepid to the touch ;
Ting'd still with purple dye, and brandish'd o'er
With trails of caustic ulcers like the blaze
Strew'd by the holy fire. But all within
Burn'd to the bone : the bosom heav'd with flames
Fierce as a furnace, nor would once endure
The lightest vest thrown loosely o"er the limbs.
2. Jlnihracia Rubula. From rubus the " black-berry" or " rasp-
berry ;" in French framboise^ whence the common but barbarous
name of frambaesia : which is here attempted to be exchano-ed for
an euphonous and strictly classical term, in perfect accordance with
the ordinary law of diminutives, which seems to prevail through the
general nomenclature of exanthematous diseases. Perhaps mo™/a,
from morus, a word employed in an approximating sense by Plau-
tus, might have been somewhat more appropriate, since the erup-
tion seems to bear a nearer resemblance to diminutive mulberries
than raspberries. But as the latter plant appears to have laid a
foundation for the name both on the African and American coast, on
the former of which it is called Fare;, and on the latter Pian, or
Epian, both which, as we are informed by Sauvages, import rasp-
berry ; and as the earliest writers have, upon this authority, deno-
minated it framboise^ ov frambaesia^ the author has not felt himself
at liberty to deviate from the original idea.

182 NOSOLOGY. [CL. Ill.-OR. IV.

Plan. Native American.

See Schilling De Morbo in Europa pane ignoto, quem
Americani vocant Yaws. As also Sammlung fur "prack-
tische Aerzte. Band vii. Stiick. 2 and 3.

ORDER IV.

DYSTHETICA.

CACHEXIES.

iVIorbid state of the blood or blood-vessels ; alone, or cori'
nected with a morbid state of other fluids, producing a diseased
habit.

There has been a still greater diversity of opinion concerning the
proper situation of this species than of plague. It has been gene-
rally placed in the class of cachexies ^ by Sauvages and Sagar ii»the
order of tubera ; by Cullen in that of impetigines. These writers
take little or no notice of any kind of febrile symptoms that accom-
pany it whether specific or symptomatic. "Nulla febris acuta,"
says Sauvages, " hunc morbum comitatur ; verum ex hoc negleclo
morbo vel non sanato^ sequitur ssepi; macies insignis, phthisisque ac-
cidente lienteria lethalis." Dr. Young pays as little attention to the
febrile symptoms by which it is said to be distinguished, and at the
same time transfers it from the division of cachexies (cacoc/iymite, as
he denominates them,) to the order of paramorphia; or structural
diseases. Dr. Winterbottom and Dr. Dancer, on the contrary, con-
tend that a slight fever is its primary symptom ; and Dr. Ludford,
to whom we are indebted for, perhaps, the best history, which has
yet been given of this disease, describes it as a proper eruptive
fever totally unconnected with diet, lues, or any other taint in the
blood; commencing with alternatives of shivering and heat, lassi-
tude want of appetite, and pains in the head and loins so great as
to prevent sleep; the fever and every inconvenience diminishing
after the eruption, and the appetite returning. So that like the
small-pox it appears to have a regular accession, height, and de-
cline • and, as already observed, may be propagated by inoculation,
and is never known to occur a second time. Hehce Parr, who
seems for a long time to have wavered in his opinion concerning
the real nature of this disease, regarding it in his article Cutanei
MoRBi as a pustulous cxunthem^ and in his Nosology as a mere cnti-
cular intumescence^ ord. x. sect. iii. (3, returns with a decided mind to
his lirat opinion in the article Yaws, and asserts that " the detail of
symptoms shows that the disease is truly exanthcniatous."

CL. III.-OR. IV.] NOSOLOGY. MiS

The words hitherto ordinarily used to import the diseases,
meant to be comprehended under this term, are, cachexia, and
impe igo, or as the Greeks express themselves At/jjs, lues, or lyes.
None of the^e, however, exactly answer ; and that on two ac-
counts; firstly, because dysthetica is here limited to those de-
pravities which seem chiefly to originate from, or manifest

This view of the subject will perhaps justify the present position
of the disease; support its pretensions to the character of a carbun-
cular exanthem, and consequently develop the nature of its connex-
ion with plague under a nosological arrangement founded on the
principles of symptoms.

Order IV. Dysthetica. From nhuty whence ivrig^ krvi?, princi-
piurn ; ^va-^iriu, mule affectiis sum ; iv^ia-tccy employed both by Hippo-
crates and Galen as bene constituta corporis habitudo. Cachexy, even
among the Greeks, embraced at least two very different kinds of
morbid constitution, as we learn from various parts of Celsus: the
one appertaining to old age, the other to a tabid or consumptive
habit in earlier lile. Compare lib. ii. cap. i. ver. fin. with lib. iii.
cap. xxii. ad. init. But in modern times the term has been used in
such a variety of ranges and significations, as to bid defiance to
every attempt at generalizing its meaning. Thus in Sauvages, Vo-
gel, Sagar, and Cullen, it occurs as the name of a class; but under
each of them is made to embrace very different diseases; the classi-
fic character being sometimes depraved external colour alone ;
sometimes depraved colour and form ; sometimes depraved colour,
form, and size ; and sometimes, as m Dr. Cullen's definition, de-
praved habit of the whole or a great part of the body, without any
notice whatever of the three precedmg qualities. In Macbride and
Parr, Cachexy is introduced as an order, for in these writers the
order constitutes the primary division; yet nothing can be more at
variance than their separate definitions of this order; for while the
former makes it far more comprehensive than any prior nosologist,
embracing polysarcia, emphysema, tympanites, physconia, osteosar-
cosis, sarcostosis, mortificatio, and many other diseases scattered
through very widely separated classes of other writers ; the latter con-
fines it to two genera of diseases alone, impetigo and macula, (impetigo
being here used in a very contracted sense,) and defines it " a change
in the colour of the skin, generally from a chemical change in the
nature of the fluids." Linneus, again, employs the term in a still
more limited sense than Parr, reducing it to a mere genus of the
class deformes, order decolores, and characterising it by depraved
twani of colour, " pa//or corporis oedematosns, cum debilitate, moe-
rore." While later writers', as Young and VVillan, have omitted the
term altogether ; the former substituting cachochymia; as synonymous
vfith its more general meaning; and the latter breaking up the en-

184 NOSOLOGY. [CL. III.-OR. IV.

themselves in, the sanguineous function, either as it regards its
vessels or its fluids ; and secondly, because no determinate
sense has hitherto been generally assigned to either of these
three terms.

GENUS I.
PLETHORA.

Complexion florid ; veins distended ; undue sense of heat
and fulness ; oppression of the head, chest, or other
internal organ.

tire corps of diseases usually arranged under its banners, and scat-
tering them about equally, amidst all the eight orders which consti-
tute his system.

An equal degree of vagueness has run through the use of impetigo.
This, by most nosologists, constitutes the name of an entire order of
cutaneous diseases : according to Cullen " cachexies chietly deform-
ing the skin and external frame :" according to Sauvages and Sagar
" chronic, contagious, (or for the most part contagious) maladies,
which superinduce cutaneous excrescences, gregarious tumours, ex-
ulcerations and crusts, in many instances propagable by inoculation."
Parr reduces impetigo to a genus, though of a somewhat extensive
scale, including scorbutus, syphilis, aurigo, phaenigmus, melasma,
rubigo. Vogel, who also renders it a genus, limits it to a kind of
lichen, " macula, subrubra aspera, dura, sicca, cum ingenti prurigi-
ne ;" thus making it synonymous with the dry letter ; while Willan,
on the contrary, uses it synonymously with the running or humid
letter; and Celsus, II. xxviii. 17, with both. Linneus, Macbride,
Young, and various other nosologists, probably from the uncertainty
of the sense, have rejected the term entirely.

From the same uncertainty Sauvaj^^es rejected lues, or, as it ought
rather to be written, lyes^ and employed syphilis in its stead ; and
his example has been followed by perhaps all the later nosologists
with the exception of Macbride. " Hie ordo," observes Sauvages,
" continet morbos cutaneos, chronicos, Siepios conlagiosos, et viru-
lentos, qui ca ratione lues nominari consuevere, ut lues syphilitica,
scorbutica: verum lnis nomen tuheribus inditum est, unde lues ra-
chitica scrophulosa^ cancrosn, nomen habet."

To have employed any one of these terms therefore as the name
of the present order, would have been to add to the vagueness of
their meaning, and consequently to the imprecision of the order
itself A new term has hence been substituted, the direct scope oi

GE. I.] NOSOLOGY. 185

Plethora. Linn. Sagar.

1. ENTONicA. Pulse full, strong, rcbounding ; muscular fibres

firm and vigorous.
Sanguine Plethora.

2. ATONicA. Pulse full, frequent, feeble ; vital actions languid ;

skin smooth and soft ; figure plump, liut inex-
pressive.
Serous Plethora.

which is well calculated to embrace all those cachexis?, inipetigines,
lues, or depravations, which appear chiefly to originate in a niorbid
state of the blood, or the blood-vessels without fever, whether con-
nected or not connected with other parts of the system ; many of
which are capable of being communicated by transfusion of bloed
from a diseased to a sound constitution, and one or two of which we
have reason to believe are, in this manner, actually communicated
to the fetus in the womb. Under the order thus explained, sphace-
lus and necrosis, which are regarded as cachexies by Sauvagcs, Sa-
gar, and Macbride, have a clear title for admission; as has also ple-
thora. Polysarcia makes an approach to the division, but belongs
more properly to the diseases of Class vi, or those of the excernent
function.

Gen. I. Plethora. IJAyj^wgi:*, from srA^jd-w, " impleo," " inundo.*"
This affection, proscribed from the catalogues of Sauvages and Cni-
len, is entered, and correctly so, in the division of cachexies by Lin-
neus and Sagar. It is equally a disease of the sanguineous and the
phlegmatic temperament ; and the specific distinctions are so clear
as seldom or never to be mistaken. Perhaps it is in neither case,
at any time, a mere result of redundant blood; though, in both, this
fluid seems to be formed with peculiar facility. There is common-
ly moreover in both cases an undue degree of viscidity, or lentor as
it is usually called, though unquestionably resulting from very difi'e-
rent causes : in the first species probably from some excess of gluten
and fibrin ; and in the second from a deficiency of the neutral salts
by which the coagulable parts are to a certain extent held in solu-
tion. In both there seems also to be very generally an excess of
oxygen, and hence the florid hue the small blood-vessels communi-
cate to the surface.

Gen. II. H^MORRHAGiA. From <i«f6«, " sanguis," and pijcrs-^y, " rum-
po." There are few parts of Dr. Cullen's arrangement more open
to animadversion, or which in fact have been more generally ani-
tnadverted upon than the present. The haemorrhages, or fluxes of
blood, are with him an entire order, ranking under the chiss pyrexia?
or febrile diseases. Fever, however, is only an accidental symptom
in idiopathic haemorrhages of any kind, and has h^nce been omitte.|

186 NOSOLOGY, [CL. IlI.-OR. ly.

GENUS IL

HiEMORRHAGIA.

Flux of blood from an organ without external violence.

Haeniorrhagiae. Hoffm. Vog. Cull,

Sanguifluxus. Sauv. Sag.

Seili dem. Arab.

Bluten. G.

Hemorrhagie. F.

Heynorrhage.
1. ACTiVA. Accompanied with increased vascular action: blood
florid and tenacious.

Hasmorrhagia arteriosa. Cricht.

Haemorrhagia activa. Jluct. Var.

Cauma haemorrhagicum. Young,
et Narium. Discharged from the nostrils; preceded by
local heat and head-ache.

Epistaxis juniorum. Cull.

Epistaxis arteriosa. Cricht.

Ruaf. Arab.

Bleeding at the nose.
€ JIa?m6ptysis. Thrown up by coughing; preceded by
flushed cheeks, dyspnaea, and pain in the chest.

Eniptoe. Gordon.

Employs. Gilbert.

Haemoptoe. BoerJi.

Hasmoptysis. Sauv. Linn. Cull.

by all or nearly all other nosolog'ists : while in niany haemorrhag-es?
as the passive . here constituting the second species of the genus, Dr-
CuUen has himself found it absolutely impossilde to introduce this
symptom ; and he has hence been obliged to transfer all the passive
subdivisions or modifications to another part of his system, notwith-
standing tbi'ir natural connexion with the active, and to distinguish
them by the feeble name of profusions^ instead of by their own pro-
per title

The word hamorrhage, however, was limited by Hippocrates, as
we learn from Galen. Epidem. 1. romm. i. to tlux of " blood yj-om </tc
no.',<ri/s," as though applied KctT \lo^r,»; and he has been followed,
in this restrained use of the term, by Sauvagos and most of the no-
sologisf-i. \ ogel first pointed out the inconvenience of this limita-
tion, and exchangfd lia^morrhagia for epistaxis, th\is libernting the

GE. II.] NOSOLOGY 187

Blut-speyen. G.

Crachement du sang. F.

Spittijig of Blood.
y Haematemesis. Evacuated from the alimentary canal,
at either extremity ; with expulsive effort ; preced-
ed by tensive pain about the stomach ; and accom-
panied wilh anxiety and faintness.

Haematemesis. Sauv. et Auct. Recentior.

Vomitus cruentus. StahL

Vomitus sanguinis. Auct. Var.

Vomissement de sang. F.

Vomiting of blood.
3 Haemattiria. Evacuated at the urethra ; preceded by
pain in the region of the bladder or kidneys; and
accompanined with faintness.

Hasmaturia, Sauv. et Auct. Recentior.

Mictus cruentus. Sydenh.

Pissement de sang. F.

Bloody urine.

It is sometimes, though rarely, discharged without

any mixture of urine, and is then called by Vogel sty-

matosis. There seems no necessity for the distinction ;

though Dr. Cullen has introduced stymatosis into his

" Catalogus Morborum a no!)is omissorum."
s Uterina. Discharged from the uterus ; with a sense of
weight in the loins, and of pressure upon the vagina.

Uteri hsemorrhagia. Hoffm.

HfBmorrhaea. Dioscor.

Haemorrhagia uterine. Jimck,

Metrorrhagia. Sag.

Menorrhagia. Sauv. Linn. Vog. Cidl.

Uterine hemorrhage.
^ Proctica. Discharged from the anus spontaneously ;

former term to express flux of blood generally; and Cullen, Cricb-
ton, and most later writers have followed his example. In point of
precision, however, epistaxis, (£i»-<«-T«|<?,) has nothing more to boast
of than hcEinorrhagia : for in its radical sense it imports distillation ;
though it is employed in a very restrained sense by Hippocrates, to
express habitual haemorrhage or distillation of blood from the nose.
Haematemesis is here used in the same latitude as vomica, (see apos-
tema Vomica^ and imports flux of blood below as well as above.

Plants are subject to a similar disease ; and that too both of the
active and passive kind. The first is from a plethora or super-

liiB NOSOLOGY. [cL. III.-OR. IV.

with a sense of weight, and pain within the rectum ;

and often of load in the head.
Hasinoirhois. Suuv. Sag» Linn.
HasmoiThois fluens. Cull.

2. PAssiVA. Accompanied with general laxity or debility; and

weak, vascular action ; blood attenuate, and of
a Modena red.
Haemorrhagia venosa. Cricht.
Haemorrhagia passiva. Juct. Var.
Profusio. Linn. Cull.
Profusio haemorrhagica. Young.
tt Narium. Discharged from the nostrils without local heat

or head-ache.
S HaBmoptysis, Thrown up from the respiratory organ,
usually with coughing; often accompanied with scir-
rhous or calculous affection ; countenance pale and
emaciated.
y Haematemesis. Evacuated from the alimentary canal
at either extremity with expulsive effort, nausea and
faintness ; but without tensive pain.
§ Haematuria. Evacuted at the urethra ; usually with

faintness, but without previous pain.
£ Uterina. Discharged from the menstrual organ, with a

sense of local weakness.
'C, Proctica. Discharged from the anus spontaneously;
with little or no pain ; usually with varices or con-
gestions of the haemorrhoidal veins ; occasionally pro-
ducing a habit.

3. vicARiA. Catenated with a morbid or suppressed action of

some other organ ; the outlet being usually the

nostrils, tracheajVagina or rectum ; at times the

urethra.

The first species found occasionally as a symptom in

plethora ; various species of fevers ; various species of

abundance of sap, which in drupous fruit-trees flows from the rup-
tured vessels, intermixed with a considerable proportion of gum :
but, in the vine, is a clear attenuate lymph, totally destitute of gnm.
The latter relieves itself by the discharge, and no evil follows ; but
the former soon become weakened, and should have the wound
closed by a plaisler or cement of wax, or some similar material. In
the passive species the sap is often peculiarly thin and acrimo-
nious ; the tree wastes rapidly, and no mode of treatment seems to
avail. Tbe birch and oak bleed profusely upon being wounded, and
the tree often dies if the wound be not attended to.

GE, II.] NOSOLOGY. 189

empresma ; melaena ; and in marasmus Phthisis. The
second in marasmus Tabes and Atrophia, struma and
porphyra.

GENUS III.

MARASMUS.

Emaciation of the entire body.
Macies. Sauv. Sag.
Marcores. Cull.

Kedazesh, of Persian origin, from solvo, liquifio.
Emaciation.
1. Atrophia. Complexion pale, often squalid ; skin dry and
wrinkled ; muscles shrunk and inelastic : lit-
tle or no fever.
Atrophia. Sauv. Linn, Vog, Sag. Cull.
Verem. Arab,
Atrophy.

» Inanitorum. The crasis of the blood vitiated by exces-
sive evacuations ; as saliva, sweat, milk, intestinal
secretion, or blood itself.
Atrophia inanitorum. Cull.
C Famelicorum. The crasis of the blood vitiated by
the use of food deficient in quantity, or innutritious
in quality.

Gen. III. Marasmus. Mie^ats-iMcs, from (it«g««»», *' marcesco," " mar-
cescere reddo." This term was long ago used collectively to com-
prehend atrophy, tabes, and pthisis ; and in employing it therefore
as a generic name, the author only restores it to its earlier sense.
There is a common character, by which all the diseases to which it
applies, approach each other, and under which they should in the
first instance be arranged : that character is a general emaciation of
the frame. Atrophia is deduced from «, privative, and r^t^u, " nu-
trio." Tabes is a Latin term, of doubtful origin, probably from the
Hebrew IJ^H, {tab,) " to pine away or consume ;" though usually,
but idJy, derived by the Latin lexicographers from the Greek rxxu,
rx^u. or ^xTTTu, with all of which it appears to have very little con-
nexion either in sense or sound.

190 NOSOLOGY. [CL. IIl.-OR. IV.

Atrophia famelicorum. Cull.
y Debilium. The crasis of the blood vitiated by in-
firm action of the digestive faculty : as in puny
infants, and feeble age.
Atrophia debilium. Cull. The atrophia cachochy-
mica of this author seems rather to belong to the
next species.
2. Tabes. General languor ; hectic fever ; for the most part
depressed spirits.
Tabes. Sauv. Linn. Vog. Sag. Cull. .
?Iulas. ^rab.
Verzerhung. G.
Etisie. F.
Decline.

et Purulenta. The blood vitiated by absorption of pus
from an external or internal ulcer, or a vomica.
Tabes purulenta. Cull.
C Strumosa. Vitiated by a scrophulous taint; and, for

Marasmus is not uncommon among' plants ; and this too perhaps-
in both the first and second species here offered, so far as the terms
will apply to the vegetable world. The trees affected are often
found to droop, decline, wither, or become emaciated and perish,
sometimes suddenly, often with a slow progress. Frequently the
cause is unknown; yet more generally it is referable to improper
soil or planting, to invermination, or phthiriasis, mails in the present
system.

In plantations of pine-trees this affection is sometimes epidemic,
and from the extensive mischief that ensues, has been called, but
improperly, teredo Pinoruin. Accor.iing to Wildenovv it attacks
principally the alburnum and inner bark. The first symptom is a
reddish yellow hue ifi the acerous leaves; then the appearance of a
great number of minute drops of resin in the middle of the boughs,
with an offensive terebinthinous smell spreading far around ; the
bark scales off, and the liber, ot'ten the alburnum, presents a blackish-
blue appearance. The tree is next covered with insects. The
causes are long continued dry weather;- severe and long continued
firost, suddenly supervening upon warm weather: and violent gales
of wind. Thf disease is incurable: and the only thing to be done in
large forests is to forbid clearing away the leaves or the moss around
the roots, as this will only increase the weakness of the tree, and
render it still tenderer.

3. Marasmus Filiisis. This disease is said to be indigenous to the
British Isles; and I'lore is perhaps some truth in the re[)ort, for we
meet with various notices of it in an early part of Anglo-Saxon his-

«E. III. J NOSOLOGY. 191

the most part, connected with a scrophulous affec-
tion of some organ or other.
Tabes scrophulosa. Cull.
y Dorsah's. Vitiated by excess in libidinous indulgen-
cies. Accompanied with pain in the back and loins;
sallow, dejected visage; heaviness of the head;
sjrigmus ; sleeplessness ; horror of mind ; extreme
genital debility.
Tabes dorsalis. Lnmm. Sauv.
Phthisis notias, ((pSia-n toTiuf.) Hippocr. Literally Hu-
mid tabef: ; so called from the frequent and involun-
tary secretion of a gleety matter.
Venenata. The blood vitiated by an introduction of
some poisonous or other deleterious material 'into
the system; often from the injudicious use of quick-
silver ; perhaps, at times, from small portions of
arsenic. See Sauv. in verb. Amali, Cent. ii. cur.
Go.
Tabes venenata. Cull.
Tabes a veneno. Sauv. ,

3. PHTHfsis. Cough : pain or uneasiness in the chest, chiefly
on decumbiture ; hectic fever ; delusive hope
of recovery.
Phthisis. Auct. Gnec. Sauv. Linn. Vog.
Haemoptysis phthisis. Cull.

tory, under the name o^imgen-adl, (lungs-ail:) and in the Cottonian
MSS. in the British Museum, Lib. Vitell. 8, we have the following
prescription, which appears to have been much in vogue, and is here
copied as a curiosity " Take hwite hare hunan, (white horehound,)
and ysypo, (hyssop,) and rudan, (rue,) and galinc, (sow-bread,) and
brysewyrt, and brunvvyrt, (brown wort,) and wude merce, (parsley,)
and grundeswylian, (groundsel ) of each twenty penny-weights; and
one sestfer-full of old aie, (fifteen pints;) and sethe the herbs till the
liquor be half boiled away. Drink every day fasting a neap-full
cold, and in tl^te evening as much warm."

The varieties of phthisis offered in the present system, are taken
from Dr. Duncan's very valuable " Observations" on this disease ;
in which, however, as phthisis is there introduced as a genus, th^
present varieties occnr as species. Yet as the tuberculous may run
into thf; apostematous modiiication, and the catarrhal into both, ac-
cording to the peculiarity of the constitution, and other concomitant
circumstances ; and more cspeciall}' as the same cause may produce
each of them in different idiosyncrasies, the present subdivision of
them may perhaps be regarded as the more correct.

392 NOSOLOGY. [CL. III.-OR. IV.

Phthisis pulmonaris. Mort.

Phthisis pulmonalis. Duncan, et auct, var,

Soollal (Arab.) Literally morbus pulmonaris, from sooll,
pulmo.

Schwindsucht. G.

Phthisic. Consumption. F.

Phthisic. Consumption.

•5 Catarrhalis. Cough frequent and violent ;"5:opious
excretion of a thin, offensive, purulent mucus ; ge-
neral soreness in the chest, with transitory pains,
shifting from side to side. Chiefly produced by
catching cold, or the neglect of a common catarrh.
Catarrhal Consumption. Duncan.
;'_ C Apostematosa. Cough severe but dry ; fixt, obtuse,
circumscribed pain in the chest, sometimes pulsa-
tory : difficult decumbiture on one side : at length
sudden and copious discharge of purulent matter,
occasionally threatening suffocation : the other
symptoms temporarily, rarely permanently, reliev-
ed. Chiefly the result of repeated haemoptysis.
Apostematous Consumption. Duncan.

y Tuberculosa. Cough short and tickling ; excretion
of a watery, whey-like sanies, sometimes tinged
with blood : pain in the chest slight : habitual ele-
vation of spirits. Usually the result of a scrophu-
lous diathesis.
Tubercular Consumption. Duncan.

The teeth during this disease often assume a
milky whiteness ; the eyes a pearly lustre.

Gun-shot wounds are rarely followed with con-

To allay the irritation of the cough, Dr. Duncan recommends the
use of lettuce-opium, or the inspissated juice of the common lettuce
of the garden, which he denominates lactucarium ; and which he
has tried apparently successfully under the various modes of tinc-
ture, pills, and lozenges, for each of which he offers an elegant
formula.

By Dr. Cullen phthisis is contemplated as nothing more than a
sequel of haemoptysis, instead of being regarded as an idiopathic
disease ; and his species, which are two, can only be viewed, and so
appear to have been by Dr. Cullen himself, as separate stages in the
progress of the complaint : his first species being denominated p.
incipiens, and characterised by an absence of purulent expectora-
tion ; and his second p. conjirmaia, distinguished by the presence of
this last symptom.

GE. IV.] NOSOLOGY. 193

sumption. "I cannot say that I ever saw a case
where such an eftect took place." Hunter on
Blood.

See Baillie, Morh. Anat. Fasc. ii. pi. 4. 2. pi. 5.
1. 2. Duncmi's Observ. on Pulmonarj'^ Consump-
tion, 1813.

GENUS IV.

CYRTOSIS.*

jHead bulky, especially anteriorly; stature short and in-
curvated ; flc:.h flabby, tabid, and wrinkled.

Gen. IV^. Cyrtosis. Kv^ravn^ " curvitas, gibbositas, distortio spi-
nae dorsi," from Kv^roi, "curvus, incurvus, gibbosus." The author
has preferred this term to the compound cyrtonosus (xt;gT«»«o-«{,)
morbus incurvus: the term moihus^ or noo-sj, being pleonastic in a sys-
tem of nosology. The character of the second species is chiefly
taken from Dr. Reeve's very excellent paper in the Phil. Trans,
for 1808, p. Ill ; which, while it establishes the disease to be he-
reditary, sufficiently proves it to originate in a close, confined and
marshy atmosphere, with inattention to cleanliness, and wholesome
food. It is a singular circumstance that both these species should
have made their first appearance, or at least have been first no-
ticed, contemporarily. The earliest account we have of rickets is
that published by Glisson, as it occurred in England in the middle
of the seventeenth century : the first account of cretinism is that
of Platter, who met with it about the same time in Carinthia and
the Valais. Praxeos Medico, cap. iii. Basil 1656. The disease is
common in Navarre, and in many of the valiies of the Pyrenees,
particularly that of Luchen ; and the unhappy victims are rumour-
ed, according to M. Kamond, to be descendants of the Cagots or Ca-
pots, who, in the eleventh century, infected with leprosy and other
cutaneous maladies, were treated as a lower order of beings; were
sold as slaves, disposed of by will, obliged to enter the church by a
separate door, and to use a particular font and seats, which were
placed at a distance from the rest of the congregation. Voyages
dans les Pyrenees. But this seems to be mere tradition, without a
single historic relic for its support or countenance. Zeviani, della

* [In the ' Sludi/ of Medicine,' Ci/rlosis is placed in Genus IV. Ovder I, Class VI,
See Stud!/ nf Medicine, Vol. 4ll), jjage 222.1

194 NOSOLOGY. [CL. IlI.-OR. IV.

1. Cretinismus. Chiefly affecting the head and neck : counte-
nance vacant and stupid : mental facuhies
feeble or idiotic ; sensibility obtuse ; most-
ly with enlargement of the thyroid gland :
hereditary.
Cretinismus. Platter. Prax. Med.
Creiinism. Reeve. Phil. Trans. 1808.
"2. Rhachia. Chiefly affecting the limbs and body ; spine
crooked ; ribs depressed ; articular epiphyses
enlarged and spongy ; belly tumid ; mental
faculties clear ; often premature.
Rachitis. Glissoyi. Sauv. et Auct. Alior.
Rijckgrat-kranckheit. G.
Noiiage Noiieure. Riquets. F,
'' Rickets.

Found occasionally also as a symptom in strumay
trichosis, phthisis, and elephantiasis. Sauv. in loco ;
and hence occasionally commencing in adults. Journ.^

Rachitide, contends that rickets, if not cretinism, were known to the
ancients, and alludes to the names of Vari, and Volgi among the
Romans, and to various passages ridiculing deformity, in Thersites,
the supposed jEsop of Greece, a? well as in other authors, in proof
of his opinion : but all such remarks are too general; he cannot
produce a single passage from the medical writers of antiquity,
clearly characterising the peculiar deformity before us. Hahn has
attempted to do so in the works of Hippocrates, but has failed : and
hence it is generally admitted, and has been so from the time of
Glisson himself, supported by the concurrent opinions of Bate, Re-
gemorter, Van Swieten, and Trinka, that both rickets and cretinism
are of recent date.

There is some doubt about the origin of both names. Cretinism
was at first ascribed by different writers to two causes, with neither
of which it appears to have any connexion; the habitual use of
snow-water ; or of water impregnated with chalk [creta] in the low
Swiss vallies in which it was first traced : and it is probable that the
term cretinism is derived from the latter opinion. There is some
uncertainty, however, upon this subject, but the name may stand ;
the best descriptions of it that have occurred to the writer of these
pages are that given l)y M. Pinel in his Traite snr ^Alienation Men'
tale, sect. iii. § ISf, chiefly drawn up from M. Fodere ; and that of
Dr. Reeve, in the Phil. Trans, for 1H08.

The term rickets, is usually translated in medical language rhachi-
tis, a name first given to it by Glisson, as though derived from
P«X'5 (rhachis,) the spine, in consequence of the distortion and cur-
vature of this organ, produced by its being no longer able to bear

GE.

v.] NOSOLOGV. 1 95

de Med. xliii. Dr. Young regards it as a regular spe-
cies of scrofula; and hence in his system it occurs un-
der the title of scrofula Rachitis.

GENUS V.
ALPHOSIS*

Cuticle dead-white ; pupils rosy ; corporeal powers weak,
i. iETHiopicA. Hair white, and woolly ; irids white ; sight
strongest in the shade. Found among ne-
groes.

the weight of the head and upper extremities. As this malady, how-
ever, was first traced in England, and appears to have been known
in the western counties, and provincially denominated rickets^ be-
fore it attracted the attention of medical writers ; it is probable that
the term rarhitis was employed by Dr. Glisson as much on account
of its resemblance to the English term rickets, as from its express-
ing the diseased state of the spine. Dr. Johnson, indeed, derives
the English rickets and rickety from the Greek rhachilis, usually
but improperly written rachitis: but this is to commit an anachro-
nism, rickets and rickety being in use first, and perhaps derived
from the German and Teutonic riicken, " to rock, reel, wriggle, or
go unsteadily." Rhachitis might, however, be a very good word,
were it not for its termination ; — itis^ in the medical technology of
modern times, implying organic inflammation, and being limited by
a sort of common consent, to the numerous species of disease, in the
present method, arranged under the genus empresma, CI. III. Ord.
ii. : whence the author has exchanged rhachitis for rhachia. If,
however, this disease were known among the Greeks, it must be
sought for under the name here given to the germs — that of cyrto-
sis ,• for this is a term common to Greek writers, signifying incurva-
tion generally, and incurvation of the spine peculiarly ; in other
words, posterior crookedness, as AogS«(r<5 (lordosis) its opposite, im-
ports anterior crookedness, or the procurvation of the head and
shoulders.

Gen. V. AiPHosis. The character of the genus and species is
drawn up from the descriptions of Saussures, Manpertuis, Bazzi, and
Blumenbach. The whiteness is probably produced by a want of the
secretion of the pigment that among negroes renders the rete mu-

* [In the ' Study of Medicine,'' Alphosis is not ranked as a genus, but is the 7tl)
species, 10th genus, 3d order, 6th CI^'^f. Spo Study of Medicine, Vo). 4th, page
466.] •

1,^6 NOSOLOGY. [CL. III.-OR. IV'

-jEthiops. Ploitquet.
Albor cutis. Plenck.
Weissehaut. G.
Albino.
2. EUROP.T.A, Hair flaxen and silky : irids rosy. Found

among Europeans and other white nations.
Trail in Nicholson's Journ. of Nat. Phil.

See also Blumenbach^ Med. Bibl. ii. 537. Le

Cat^ Traite de la Couleur dela Peau Hu'

maine. Phil. Trans, passim.

GENUS VI.

STRUMA.

Indolent glandular tumours, chiefly in the neck ; suppurat-
ing slowly, and imperfectly, and healing with difficulty ;

cosum black ; and which does not usually take place till several
weeks, sometimes months, after birth ; the negro child being fair
when first born. The Spaniards and Portuguese denominate those
who are thus affected Albinos; the French, Blafards ; the Dutch,
Kacklacken.

As the present page is a cancel, and has consequently been work-
ed off after the rest of the volume, the author takes the opportunity
of requesting bis readers to correct the numerals of the specific
names under the geiuis Puyma, p. 122, from 2, 3, 4, to 1, 2, 3: and
to give to the names of the species and varieties under Ulcus, p,
216, &c. a neuter instead of a masculine termination, as vitiosum^ callo-
sum,* &c. : the author having at first employed a masculine noun in-
stead of ULCUS ; and it having escaped his attention to make the ne-
cessary emendation on a change of- the generic term. He has also
to entreat the reader's correction of a few other errors that will oc-
casionally occur to him, chietly typographical, and mostly in the
accentuation, and the use of a large or small capital in the com-
mencement of certain specific names : it being uniformly intended
to employ a large capital whenever a species is distinguished by the
name of an old genus, or a substantive of a similar kind in the
nominative case; and never otherwise.

Gf.n. VI. Struma. This is the name in Celsus, who well de-
scribes the disease, lib. v. cap. xxviii. it is probably derived from

*f These are corrected m the American erlition. I

GE. VI.] NOSOLOGY. 197

upper lip thickened ; skin smooth ; countenance, usually
florid.

Struma. Cels. Linn, et Auct. Var,

Choiras (;to«g«5.) Auct. Grczc.

Scrophula, or scrofula. Sauv. Vog. Sag. Cull.

Silat (Arab.), from " tumor," " tuberculum." In Persian
Damghul; in Turkish Aur.

Kropff. G.

Ecrouelles. F.

King^s evil.

1, VULGARIS. Confined to the external, conglobate glands : tu-

mour pea-sized, or chesnut-sized ; appearing
in infancy or youth ; subsiding on mature age ;
hereditary.

Scrophula vulgaris. Warthon. Sauv. Cull.

Cyrnl, or plurally Cyrnlu. Anglo-Sax. Whence the,
English word kernel.

2. MESENTERicA. Affecting the mesenteric glands ; countenance

pale ; appetite infirm ; abdomen tumid; ex-
crements usually peculiarly fetid.
Scrophula mesenterica. Sauv. Cnll.
Chartre. Puzos. " Maladies des Enfans."

Found also, occasionally, as a symptom in scalled-
head, yaws, and other cutaneous eruptions.

Swine are said to be peculiarly subject to this disease :
on which account it was vulgarly called choiras and
scrofula, or sivine-cvil, among the Greeks and Romans.
Sauvages has denominated the porcine species scrofula
chalasis : it is named by Gilbert, De Lepra, scrofula
leprosa, and by Leger, ladrerie des pores.

It is to this genus also that the glandular disease of

oTp«^«, " congestion or coacervation,'' as of straw in a litter, feathers
in a bed, or humours in the body: in which last sense Cicero ele-
gantly employs it as a metaphor in the phrase "struma civitatis,"
the scrofula of the state. As struma is derived from <7Tg«,M.<» so is
sr^afAx from <rTg&»v»t;» or (rr^myv^t, '• sterno. dejectum expando humi."
The medical dictionaries and glosjiaries concur in deriving struma
from struo^ but erroneously ; the terminating syllable of struma suf-
iiciently proves it to be derived from a Greek source. The syno-
nyms are scrofula or scrophula, and choiras, or choeras : the first
deduced from the Latin, and the second from the Greek, and im-
porting the same radical idea of swine-swellings^ or morbid tumours
to which swine are subject.

198 NOSOLOGY. [CL. III.-OR. IV-

horses, usually known by the name of Farcy, is com-
monly referred. It occurs in Sauvages under the title
of scrofula Farciman : and is unquestionably propaga-
ble by transfusion of blood from the diseased horse,
not only to other horses, but to asses, as has been
lately proved by professor Coleman at the Veterinary
Institution.

GENUS VII.

CARCINUS.

Scirrhous, livid tumour, intersected with firm, whitish divergent
bands, chiefly of the secernent glands ; pains acute and
lancinating: often prop;igated to other parts ; terminating
in a fetid, and ichorous ulcer.

Carcinus (xuf^mi.) Hippocr. et Auct. Grcec.
Carcinoma. Diosc. Sauv. Linn. Vog. Sag, Young.
Cancer. Machr. Cull. Parr.
Serataun. Arab.
Krebs. G.
Cancer. F.
Cancer.
1. VULGARIS. Tumour burning, knotty, with dark, cancriform
varices ; ulcer, with thick livid, retorted lips.
" No part exempt." Fearon. Treatise on Cancer,
1784.

« PuUulans. Granulating occasionally, and giving de-
lusive hopes of a cure : pains passable.
C Spongiosus. With fungous and bleeding excrescences :
heat and pain violent.
Fungus haematodes. Wardrop.

Gen. VII. Carcinus. From ««g»<y»j, a crab ; on account of the
cancriform or crab-like ramifications of the dark, distended veins of
the cancerous tumour. The division into occult and open, or indolent
and ulcerative, introduced by Hippocrates, and continued to the
time of Boerhaave, is unnecessary and incorrect There is but one
known species, of which these characters constitute only different
degrees or stages.

The question is of far more consequence whether cancer be a

GE. VIII.] NOSOLOGY. l99

Carcinoma sponjSjiosiim. Young;,

Bierchen m:ikes five vnrielies. frennine, strumous,
syphilitic, fungous, noma. Abhatidlung, ^c.

GENUS VKI.

LUES.

Ulcers on the genitals, inguinal buboes, or both, after impure
coition ; succeeded by ulcers in the throat, copper-colour-
ed spots on the skin, bone-pains, and nodes.
Syphilis. Sauv. Young.
Venereal. Disease,
i. Syphilis. Ulcers on the genitals circular, ungranulating,
thickened at the edge ; those of the throat deep
and ragged ; symptoms uniform in their pro-
constitutional or a local, an hereditary, or merely an occasional dis-
ease. By its present arrangement it is obvious to which side the
author inclines; but the inquiry cannot be discussed in a note.
Much has been said, and well said, on both sides. Till of late, the
disease was generally regarded as a constitutional affection, and will
for the most part, therefore, be found in the division of cachexies,
from Sauvages to Macbride. Many of the best writers and practi-
tioners of the present day, however, among whom are Dr. Baillie
and Mr. Abernethy, concur in regarding it as merely local. Parr,
in his Dictionary, art. Cancer, has examined the subject fairly, and
given to the arguments on both sides their due weight. He strong-
ly contends, however, for its being a constitutional, and, in various
instances, an hereditary, affection. Perhaps, like gout, it is in some
instances hereditary and constitutional, and in others original and lo-
cal. Dr. Crawford, on analysing the discharge from a cancerous
ulcer, detected in it a considerable portion of hepatised ammonia ;
and Parr, in consequence, supposes the carxerous diathesis to de-
pend on an access of ammonia, and sulphur in the blood. Dr.
Adams is well known to have ascribed the disease to a peculiar spe-
cies of hydatids.

Gen. VIII. Lues. From Akw, " solvo, dissolve," " to macerate,
dissolve, or corrupt.' Agreeably to the common rule of express-
ing the power of the Greek u by a Roman ?/, this should be written
lyes ; but the contrary has obtained so long and so generally, that it
would be little else than affectation to attempt a change.

206 NOSOLOGY. [CL. Ill.-OR. IV.

gress ; yielding to a course of mercury ; not

known to yield spontaneously.
Syphilis. Linn. Vog. Sag. Cull.
Syphilis venerea. Sauv.
Syphilis maligna. Young.
Lues venerea. Astruc. Macbride.
Frenk zchemeti. Arab.
Frantzosen. G.
Verole. F.
Pox.

That acrimonious and poisonous materials are at times secreted
by the genitals, capable of exciting local and perhaps constitutional
affections in those who expose themselves to such poisons by incon-
tinent sexual intercourse, appears to have been known to the world
from a very early age. Celsus enumerates various diseases of the
genitals, most of which are only referable to this source of impure
contact : but the hideous and alarming malady, which was tirst no-
ticed as proceeding from the same source towards the close of the
fifteenth century, and which has smce been called almost exclusive-
ly venereal disease, has suppressed, till of late, all attention to these
minor evils, in the fearful contemplation of so new and monstrous a
pestilence; to various modifications of which most of the anterior
and slighter diseases of the same organs seem to have been loosely
and generally referred ; as though there were but one specific poi-
son issuing from this fountain, and consequently but one specific ma-
lady.

The keen and comprehensive mind of Mr. John Hunter first call-
ed the attention of practitioners to the idea of different poisons and
different maladies; and the subject has since been pursued by Mr.
Abernethy with a force of argument, and illustrated by a range of
examples, that seem to have put the question at rest. The latter
has sufficiently established, that independently of the specific disease
now generally recognized by the name of syphilis, there are nume-
rous varieties of some other disease, perhaps other specific diseases,
which originate from a distinct, possibly from several distinct, poi-
sons secreted in the same region from peculiarity of constitution, or
causes hitherto undiscovered ; and which are accompanied by pri-
mary and secondary symptoms that often vary in their mode of ori-
gin, succession, and termination from those of genuine syphilis;
though in many instances they make a striking approach to it : and
to which, therefore, Mr. Abernethy has given the name of pseudo-
syphilitic diseases.

Whether these really constitute distinct species of disease, issuing
from distinct sorts of infection, or are mere varieties or modifica-
tions of one common species produced by one common morbid se-
cretion, has not yet been sufficiently determined. In this ignorance

Gb. VIII.] NOSOLOGY. 201

The above Arabic is literally Morbus Gallicus : but
the more general name is (nar i'arsi,) or (ateshi Farsi,)
according as the Arabic or Persian language is made
use of; both meaning equally Ignis Persicus, or Persian
Fire. By this name it is constantly denominated by
the Cabirajas or physicians of India. — The name is pro-
bably taken from Avicenna, who thus distinguished the
malignant carbuncle, to which syphilitic eruptions are
supposed, in the east, to have a near resemblance. See
Phyma Anthrax.

upon the subject it is better, for the present, to regard them in the
former, as being the more simple, view ; — the author has hence
given to this species the name of syphilodes, and has arranged 'it,
along with syphilis, under the generic term lues. The sibbens or
sivvens of Scotland seems to appertain to this species.

The origin of the term syphilis is not exactly ascertained. Dr.
Turton spells it siphilis, and derives it from <r<pA«s [siphlus) " foul or
iilthy ;*' Sauvages, from o-v* (syn,) " together," and ipiMa {phileo)
"to love," — "• mutual love :'''' in which case it should be spelt ac-
cording to the common rule. Tha latter, who introduced the term
into the nosological catalogue, appears to have derived it from Fra-
castoro, who was born at Fadua in 1483, and died in 1553, and who
spells it, in his very elegant poem De Syphilitide, upon this very in-
elegant subject, agreeably to the usual mode. There is an equal
uncertainty as to the quarter in which the disease originated. It is
jisually ascribed to the American continent, and believed to have
been imported into Europe by the crews of Columbus on his return
home : a belief, however, which seems to be altogether without
foundation. The reader, who is desirous of examining the autho-
rity on which this opinion rests, together with the various names bv
which it was at first recognized, may consult the author's article On
Medical Technology^ in the Transactions of the Medical Society of
London, series ii. Vol. I., p. 21 and following, and the notes there
subjoined.

Linneus stands alone in arranging syphilis as an exanthem, along
vvith sraal!-pox and measles. He thought himself justified from the
fever which occasionally accompanies the copper-coloured spots on
the skin, in an advanced stage of its secondary symptoms.

In the Amanitates AcademiccE, Vol. IV. art. 72, entitled " Specifica
Canadensium," by M. Von Coelln, we have an exact formula for ex-
hibiting the lobelia syphilitica, or Indian specific for syphilis, as de-
livered to Sir W^illiam Johnson, vvho purchased it of the Indians at
a high price.

Among the Hindus, the disease is commonly known by the name
of Persian fire; a term, however, of much earlier date than any re-
26

202 NOSOLOGY. [CL. III.-OR. IV.

2. Syphilodes. Ulcers indeterminate in their character; symp-
toms irregular in their appearance ; usually
yielding spontaneously'' ; variously affected
by a course of mercury.

cords we possess of the existence of syphilis, and applied by Avi-
cenna, and the writers of the Saracenic schools, to a particular spe-
cies of anthrax. The Hindu specific for the cure both of syphilis
and elephas is a composition of arsenic, sane' hya^ in Arabic shucc^
but which the Persians call mergi-mush^ or mouse-bane. The oxyd'
employed is the white arsenic, a. calciforme^ and the following is the
mode in which the medicine is prepared, as given in the Jtsiaiic Re-
searches^ Vol. II. art. viii. " Take of sane' hya {white arsenic) fine
and fresh one tola, (equal to 105 grains) ; of picked black pepper
six times as much ; let both be well beaten at intervals for four days
successively in an iron mortar, and then reduced to an impalpable
powder in one of stone with a stone pestle, and thus completely le-
vigated, a little water being mixed with them. Make pills of them
as large as taresor small pulse, and keep them dry in a shady place.
One of the pills must be swallowed morning and evening with some
betel-leaf; or where betel is not at hand, with cold water. If
the body be cleansed from foulriess and obstruction by gentle ca-
thartics and bleeding, before the medicine is administered, the re-
medy will be the speedier." The Cabiraja, or Hindu physician re-
lies implicitly on the virtues of this composition, and confidently
predicts the most certain success in both the above diseases. The
cathartic, previously employed, is commonly manna, which is work-
ed off with copious draughts of a cooling decoction of the nilufer oi'
nymphaea nelumbo.

See also Sir William Jones's Works, Vol. I. p. 553, 4to. edit.

Gen. IX. Elephantiasis. From e>is(p««, " an elephant:" so deno-
minated by the Greek physicians, because the skin of persons af-
fected with this disease resembles that of the elephant in thickness,
ruggedness, insensibility, and dark hue. Thus applied, therefore^
the term imports elephant-skin; in the same manner as the same na-
tional school denominated dandriff pityriasis, bran-skin ; from the
skin under this disease resembling branny scales ; and another sort
of scaly malady ichthyiasis, or Jish-skin^ from the resemblance of
the skin when thus afl'ected to the scales of the finny tribes.

The Greeks became first acquainted with the elephantiasis from
their casual intercourse with Egypt. To this quarter Lucretius,
adopting the common opinion, ascribes its origin, lib. i. vi. 112:

Est ELEPHAS morbus, qui propter flumina Nili,
Gignitur iEgypto in media, heque praeterea usquam.
High up the Nile, 'mid Egypt's central plains.
Springs the black leprosy, and there alone.

GE. IX.] NOSOLOGY. 203

Pseudo- syphilitic Disease. Aberneth.
Syphilis pseudo-syphilis. Young.
Sibbins. Sivvens. Qu ?

The varieties seem to be numerous ; but have not,
hitherto, been sufficiently defined for classification.

GENUS IX.
ELEPHANTIASIS.

Skin thick, livid, rugose, tuberculate ; insensible to feeling;
eyes fierce and staring; perspiration highly offensive. ".

Arabia, however, seems rather to have been the prolific source
of this terrible scourge than Egypt ; if we may judge from what
seems highly probable, namely, that this is the disease with which
Job was afflicted in Iduraea, a part of Arabia, as described in the
sacred poem, that bears his name, and which affords, without ques-v
tion, the most ancient record in the world, composed in a mixt lan-
guage of Arabic and Hebrew ; and if we add to this the still more
powerful argument that the Arabic name of the disease has extend-
ed itself all over the east, and is ahnost the only name by which it
is known in Egypt, Persia, and India, in all which regions the disor-
der is about equally common. Yet the Arabic name is not elphas or
elephantiasis^ hut juzam, literally " disjunction, amputation ;" vulgar-
ly indeed, and more generally pronounced and written judam, and
by the Turks judamlyk, from (judd,) a root which imports '' erosion,
truncation, excision ;" evidently referring to the destructive charac-
ter of the disease, and the spontaneous separation of the smaller
members, as the fingers a»d toes, when severe in its progress.

In some parts of India, however, and particularly in Mysore, it is
called also, and especially by the common people who are frequent
sufferers from it, durda, a Persian and Turkish term, applied to ele-
phantiasis emphatically ; for durd in these languages imports sick-
ness, disease, or distress generally; whence durdain Arabic, as well
as in the two former tongues, is a common exclamation of distress,
" vae !" " pro dolor !"

The Arabians, however, have a malady of a very different kind
to which they give the name of elcphas, elephantiasis, or elephant-
affectitn^ in their own language dal fil, which is literally morbus ele-
phas ; and which they sometimes contract to fil or elephas alone :
so denominating the disease from its supposed resemblance to the
dark, thick, and heavy leg of the elephant : as though elephant-leg
instead of elephant- skin. It is the " swelled, tumid, or Barbadoe

204 NOSOLOGY. [CL. III.-OR. IV.

1. Arabica. Tubercles chiefly on the face and joints ; fall of
the hair except from the scalp ; voice hoarse
and nasal : contagious,^ and hereditary.
Elephas. Dioscor. lib. ii. Lucr. De Rer. Nat. vi. 1102.

leg" of modern writers. And on this account, when learning, and
especiiiliy medical learning, found an asylum, during the dark ages,
at the splendid courts of Bagdat, Bassora, and Cordova, and the
best Greek writers were translated into Arabic, or the best Greek
and Arabic into Latin, two different diseases were found to possess a
like name ; for the Greeks, notwithstanding that they had already
elephantiasis to signify juzam, could only translate dal fil by ele-
phantiasis also. And hence arose a considerable degree of confu-
sion, which has indeed continued to the present moment; for ele-
phantjiusis, (dal-til,) or '•' eie[)hant-disease," is still applied by many
writers to both these maiadios; while not a few regard the two as
nothing more than varieties of a common species, or species of a
common genus. Yet the one is a tubercniate affection of the whole
body ; while the other is a scaly affection of only particular parts,
and, commonly, of not mo;e than a single limb. As a mere variety
of the proper elephantiasis, the Barbadoes or elephant-leg, iucnemire
in the present SA'stem, occurs in the Nosology of Dr. Young ; while
Dr. Parr, in his article Elvphantiasis, confounds the two affections
tmder one general character and history. In his article Nosology,
indeed, he is not guilty of the same perplexity ; for here he con-
fines himself, under the term elephantiasis, to black leprosy alone,
but at the expense of totally omitting the Barbadoes-leg or dal-fil^
which occurs no where in the range of his classitication.

The leprosy (lepra Gra?corum,) the leuce (>i«vxj)) of the Greeks,
and the baras or beras of tha Arabians, was by many oi the Arabian
physicians, and very g-eneraliy among the people, supposed in various
cases to terminate in juzam or elephantiasis, as though these also
were nothing more than different stages or degrees of the same dis-
order. And hence another error and perplexity in medical study.
Alsahavarius thus unites them, and they are jumbled together, or ex-
plained alike, in nearly all the oriental dictionaries; in which beras
or leprosy, and jnzam or elephant-skin, are, almost without an ex-
ception, regarded as convertil)le terms; beras being sometimes ex-
plained by the name of inorcd or 6</W jnzam (the term mered signi-
fying bahlf i. e. pills carens,) and elephant-skin by that of black heras^
a name occasionally applied to it by .Avicenna. This oriental con-
fusion of two different diseases was readily copied by the first Latin
translators, till at length both in the east and west, beras or lepriasis,
though literally .scale-skin^ became a sort of fimily name (or almost
every foul dishgurement of the skin, whether tubercu!ate or scaly,
cutaneous, or constitutional. And hence the lazarettos or hosi)ital8
established for elephantiasis or black lepros}' during the dark ages,

GE. IX.] NOSOLOGY. 205

Elephantiasis. Jlretaus.
Elephantiasis. Sag. Cull.
Elephantiasis Indica. E. Orient. Sauv,
Elephantia Arabiim. Fo^.

the morbus Sancti Lazari as it was also called, were filled with pa-
tients exhibiting blotches and blains of every kind ; and are still de-
nominated, (judam khaneh,) or judam lazarettos.

In the Linnean system, elephantiasis and leprosy, and perhaps
several other diseases, are included under the term lepra: all which
the disciples of the Linnean school, consistently with a principle
already adverted to, ascribe to animacules drunk in with the com-
mon beverage of water — and especially the Gordius marinus. The
black leprosy is well described as it occurs on the borders of the
gulf of Bothnia and in Finland, in an article entitled Lepra in the
Amoenitates Academicse, Vol. VII. No. 31, by M. Uddman ; in the
course of which this opinion is plausibly and ingeniously supported.
It is also supported by M. Tonning in art. 149 of the same volume,
^niiiXedi Rariora J^orwegia ; and was, in fact, many years antece-
dently to this, suggested by M. Martin, also a pupil, and a very in-
defatigable one, of Linneus, during a tour to Norway in 1758.

At Madeira, and in some other parts of the world, elephantiasis
does not appear to be contagious, nor perhaps hereditary. Yet the
testimony of its being both, in the true elephantiasis or juzam of
Arabia and the east, is so strong and concurrent among the Hindu
Cabirajas, as well as the Arabic writers, that there can be no doubt
upon the subject. The distinction is sufficient to make a variety of
the former, if future observation should fully confirm the general
opinion.

Many of the characters here noticed are accurately and ably
pointed out by Dr. Bateman in his " Practical Synopsis of Cutane-
ous Diseases ;" to which the reader may turn with great advantage
for a fuller illustration of the subject.

2. Elephantiasis Italica. For a knowledge of this species of ele-
phantiasis, as the author ventures to denominate it, we are almost
exclusively indebted to Italian physicians, by whom it is called
pellagra or pelagra — skin- affection^ from pellis. and «yp«, a barbarous
term, as compounded of two different languages. 1 he first writer
upon the disease appears to have been Francis FrapoUi, a Milanese
physician, whose work, '' In Morbum vuigo Pelagram," &c. was
published at Milan in 1771, and who expresses himself doubtful
whether the disease, though not antecedently described, is not re-
ferred to occasionally by earlier writers, though he does not think
that the Pilarella, as the syphilis was called, when it proved depi-
latory to the chin and eye-brows, was the disease in question, not-
withstanding this seems to have been an extensive opinion at the
time. The next tract, of any note upon the subject, was published

266 NOSOLOGY. [CL. III.-OR. IV

Lepra Arabum. Auct. Var.

Juzam. Arab,

Khora. Hindust. Asiat. Research. Vol. II. 8.

Elephanta-naussatz. G.

Black Leprosy.

2. Italica. Tubercles chiefly on the body and limbs ; some-

times desquammating ; great tension of the skin ;
vertigo ; burning, lancinating pain in the head ;
melancholy ; at first remitting, afterwards fixt,
terminating in alienation of mind ; hereditary.
Pelagra. Jansen. Frapolli, Animadv. in morb. vulgo
Pelagram, Milan 1771. Delia Pelagra descrizionedi
Mich. Gherardini, Mil. 1780. Thierri^ Recueil peri-
odique d'Observations de Medicine: Paris, 1755.
Pellagra. Oleggio.
Tuber Pellagra. Purr.
Mai del sole. Mediolan.

3. AsTURiENSis. Tubercles chiefly on the hands and feet ; crus-

taceous, desquammating ; continual tremor
of the head and upper part of the trunk ;
baldness of the scalp as well as of other
parts: gloom and terror of mind.

Lepra Asturiensis. Sauv, TJiierry. Journ de Med. Male
1755.

Mai de la Rosa. Spanish.

at Venice in 1784, by G. M. H'Oleggio, under the title of Tr. Teo.
Prat, delle Malattie dell insolato di prima vera vo'gorirnente dette
della Pellagra. But the best account we have received of the dis-
ease is from the pen of Dr. Jansen of Leyden, which appeared in
1788. Dr. Jansen has entered into a very full inquiry upon every
thing that relates to it, and bis description is copied, or rather con-
densed, in the present definition. It is singular that he could not
hit upon the origin of the term, and questions whether it may not
be derived from the Greek viXxi. He tells us, that it was occasion-
ally called mal del sole, as though produced by the heat of the sun.
The cause of the disease, after all, seems uncertain ; it is found in
•various parts of Italy; but especially in the Milanese and Venetian
districts, so widely differing from each other in soil and situation,
that it can scarcely be referred to these sources. Yet it is en-
demic and hereditary ; so that the condition of the peasantry in
these regions is truly miserable. Dr. I'arr is, perhaps, the only
Avriter who has hitherto introduced this disease into a nosological
arrangement.

GE. X.] NOSOLOGl. 207

GENUS X.

BUCNEMIA*

Leg enormously tumid, and mis-shapen ; skin thickened,
livid, rugose ; often scaly ; scrotum, arms, or other parts,
sometimes participating in the aftection.
Elephantiasis. Auct. Var,
Dal fil. Arab.
Driisenkrankheit. G.
Yava-skin. Polynes Isles,
Barhadoes-leg. Hillary, Dis. of Barbad.
Glandular disease of Barbadoes. Hendy.
1, Indica. Bones and muscles of the affected limb sound; its
motion little impeded by its weight.

Gen. X. BucNEMiA, from C«w, an augmentive particle, evidently
derived from the Hebrew ^2 or HVl, (ho or hoa,) " to swell, grow
large or intumesce," and xv>)^j), " crus," or "the leg:" Uterally
hulky or tumid leg. It is, in truth, the dal fil or elephant-leg of the
Arabians, the Barhadoes-leg of modern writers, already glanced at
in the note on Elephantiasis, and for which no proper techni-
cal name has hitherto been offered : — an apology that the author
trusts will be sufficient for the present attempt. Though frequent-
ly, as already observed, called elephantiasis, from a misunderstand-
ing of the secondary meaning of two univocal terms in two diffe-
rent languages, it is without the essential character of tubercular
eruptions ; while unlike the elephantiasis, which extends over the
whole body, it is always limited, and often confined to a single limb.
It makes, however, an approach to elephantiasis, and ought there-
ibre to range near it, but it cannot be included in the same defini-
tion. It is very generally known both in the East and West Indies;
in Arabia, and along the whole range of the Polynesian Isles ; in
which last it is denominated ?,'ai;a-sA:tVi ; as being supposed to origi-
nate from drinking the heatmg beverage called yava; and, like the
gout among ourselves, is regarded in a sort of honourable light. —
Instances of it are frequently to be met with in our own country;
and in a case that occurred to the author about a twelvemonth ago,
the patient, from an attempt to repel it, was suddenly attacked with

* [In the " Study of Medicine''' this genus is transferred from this order to the
second order phlogotica, in tlie same class. In that order it is placed as the eleventh
^eniis, and is made to comprehend two species, viz. :

1. BUCNEMIA SPARGANOSIS.
2. TROPICA.

The genus Sjjarganosis, which is the tenth of the second ordor and third class, in
this work, is suppressed in that.]

208 NOSOLOGY. [CL. III.-OR. IV.

GENUS XL
CATACAUSIS.

(ieneral combustibility of the body.
Incendium spontanium. Dupont. Plonquet.
Catacausis. Young.
1. EBRiosA. The combustibility occasioned hy a long and
immoderate use of spirituous liquors ; and pro-
ducing combustion spontaneously.
, Phil. Trans. Bianchini. Vol. XLIII. Id.
Wilmer. LXIV. Journ. de Phisique, Pierre-
Aime-Lair, VAn VIII. Le Cat. Memoires.

a fit of gout in the stomach, which destroyed him in three days :
— here, however, gout was a constitutional disease.

Gen. XI. Catacausis. KxrxKxvs-is^ "exustio," " combustio," from
xxruxxiu. The only medical writer in our own country, so far as
the author is acquainted with, who has noticed this very extraordi-
nary affection, is Dr. Young, by ^vhom it is referred to under the
Greek name here applied to it. The examples of this singular
diathesis, leading to a spontaneous and fatal combustion, are so nu-
merous, so well authenticated, and press upon us from so many dif-
ferent countries and eras, that it would be absurd to withhold our
assent. In almost every instance the combustion seems to have
taken place in females, advanced in life, and immoderately addicted
to spirituous liquors. In some cases the heat that has consumed them
appears to have originated m themselves, in others to have been
communicated by a tire or candle ; but in no case has the flame or
fire tiereby excited in the body been so powerful as essentially to
injure the most combustible substances immediately adjoining, as linen
or wooden furniture. The body in several instances has been found
actually burning — sometimes with a lambent llame flickering over
it — sometimes without any flame whatever — while the application
of water has at times seemed rather to quicken than impede .the
combustion. The event has usually taken place at night when the
sufferer has been alone : it has commonly been discovered by the
fetid penetrating smell of sooty films which have spread to a consi-
derable distance ; the unhappy subject has in every instance been
found dead, and more or less completely burnt up; the burnt parts
being reduced to an oily, crumbly, sooty, and extremely offensive
matter. " I conioss," says M. I'ierre-Aime-Lair, in the Journal de
Physi(juc, Pluv. I'An. 0, " that these accounts at first appeared to me
to "be worthy of very little credit, but they are presented to the
public as true by men whose veracity seems unciuestionable. Bian-
chini, Maffei, Rolli, Le Cat, Vicq-d'Azyr, and other men distinguish-
ed by their learning, have offered certain testimony of the facts.

GE. XII.] NOSOLOGY. 209

GENUS XII.
PORPHYRA.

Livid spots on the skin from extrjavasated blood: languor and
loss of muscular strength : pains in the limbs.

Purpura. Willan. Riverii. Prax. Med. xvii. 1 .
Scurvy.
1. SIMPLEX. Spots numerous, but small and flea-bite shaped-;
chiefly on the breast, arms, and legs ; paleness
of visage.

Besides, is it more surprizing to experience such incineration than
to void saccharine urine, or to see the bones softened to such a de-
gree as to be reduced to a state of jelly ?" The reader, who is de-
sirous of pursuing this curious subject farther, and of examining the
various hypotheses by which it has been accounted for, may consult
the Phil. Trans. Vols. XLIII and LXIV. the first of which contains
numerous examples. Acta Medica et Philosophica Hafniensia ; Ency-
clopedie Methodique^ art. Pathologic Anatomy of Man, drawn up by
Vic d'Azyr; Journal de Medicine^ Tom. LIX. p. 140, 440; and Phi-
los. Magaz. Vol. VI. p. 132. He may also turn to the description of
Merille and Muraine in the Journal de Medicine^ Tom. LXIX. p.
140 ; and Duponfs " Dissertatio de corporis humani incendiis spon-
taneis." Lugd. Bat. 1736.

Gen. XII. PoRPHYRA. n«g^«f«, purpura, " purple or livid dis-
ease." Dr. Willan has used the Latin term instead of the Greek,
98 indeed have most of the nosologists ; and he has used it in a sense
very nearly parallel with its range as now offered. " With Riveri-
us and some other authors," says he, " I propose to express by the
term Purpura an efflorescence consisting of some distinct, purple
specks and patches, attended with general debility, but not always
with fever." Ord. III. p. 433. " Cases of the Purpura seem to
have been studiously multiplied in periodical publications, and in
medical or surgical miscellanies. — I consider it under all the forms
described, as pertaining to the Scurvy, though it is not always at-
tended with sponginess of the gums, and a discharge of blood from
tbem, according to the definition of Scorbutus in nosology. Whe-
ther my readers agree with me or not, they will, I think, allow that
a general view of the symptoms and causes of either the Sea-
Scurvy or Land-Scurvy, cannot properly form a part of the present
work." Id. p. 466.

Certainly these cannot in precision of language be regarded as
cmaneous diseases, and co'nsequentlv a mingte description of thenv
27

210 NOSOLOGV. [CL. Ill.-OR. IV.

Petechiae sine febre. Auct. Var.

PhcEnigmus petechialis, Sauv.

Profusio subcutanea. Young.

Rothe punkt. G.

Petccchial Scurvy.

a Pulicosa. Exhibiting a pulicose, flea-bite, or as it is
commonly called, 'f)etecchial appearance, from the
first.
Purpura simplex. Will.
£ Urticans. The flea-bite spots preceded by reddish,
rounded, and nettle-sting wheals, but Avithout a sen-
sation of tingling or itching; fugacious and mi-
gratory. Chiefly found in the summer and autumn.

could not properly form part of a work possessing this title. The
above extracts, however, are sufficient to prove that if Dr. Willan
could have treated of sea-scurvy, in the work in question, he would
and must have assigned it a place under the genus Purpura. Yet he
might perhaps as well have introduced purpura nautica, sea-scurvy,
as purpura contagiosa, the pctecchial spots of malignant fever, which
consitutes his fourth variety; since an efflorescence of this kind
has at least as little connexion with cutaneous diseases as the for-
mer, and is, in itself, no disease whatever, but a mere -symptom of
a disease. With respect to land-scurvy, Dr. Willan has actually
treated of it, and at considerable lengtii as well as with great inte-
rest; for the variety, as he calls it, though it should be rather term-
ed species, which he distinguishes by the name of purpura hcemorr-
hagica, is in fact the land scurvy of all medical writers, and is so re-
garded and acknowledged by himself In proof of this, it is only
necessary to observe that in Order I, p. 51, article Lichen lividus,
he directly translates purpura by the term land-scurvy ; and refers
us both here, and in p. 463 of the number just quoted from, to the
work of Amatus Lusitanus, published about the year 1550, and di-
rectly relating to this very disorder, or rather to all the cognate
disorders that properly a[)pertain to the present genus. After
Avhich he continues as follows: '^ Kngalenus is perhaps the first
writer wiio hns given a clear description of this disease, {purpura.)
Under the general title scurvy, he furnishes three or four distinct
cases, wherein the purple eruption was connected with a haemorr-
hage from the gums, from the lungs, or from the bowels. See Obs.
2, 33, 59, G2, 6!', 69, 72. He refers the complaint to a putrid
diathesis, produced by gross food, salt, or stagnant water, arid a moist
cold atmosphere. Dr. Lister, Exercitat. Med. de Scorbuto, 1080, af-
fords several cases analogous to those above quoted : the 1st,
5t!i. 6th. 7t!j, ^.th, 9th, 10th, 11th, and 12th, exactly coincide with my
own observations on the purpura hcemorrlwgica. 'J' he remedies on

GE. XII.] NOSOLOGY. 211

Purpura urticaria. Will.

2. HEMORRHAGICA. Spots clrcular, of different sizes ; often in

stripes or patches, irregularly scattered
over the thighs, arms, and trunk ; occa-
sional haemorrhage from the mouth, nos-
trils, or viscera ; great debility, and de-
pression of spirits.

Purpura hemorrhagica. M^ill.

Stomacace universalis. Sanv.

Ileus haematites ('lAeej uiftxTiTTn.) Hippocr.

Hagmorrhagia universalis. Wolf. Wadel, Observ. Cu-
rieuses, Tom. III.

Lands ctirvy.

3. NAUTiCA. Spots of different hues intermixed with livid, pnn*-

cipally at the roots of the hair ; teeth loose ;
gums spongy and bleeding; breath fetid; debi-
lity universal and extreme.

Occurs chiefly at sea after exposure to a moist,
cold, and foul atmosphere ; with long use of
salted food and stagnant water.

which Dr. Lister depended for the cure of these, were, scurvy-grass,
cresses, vegetable acids, and occasionally blood-letting. Experience,
however, soon taught him, that bleeding, and hkewise purging,
were highly detrimental."

Dr. Willan has well observed, that cases of purpura have been
unnecessarily multiplied ; and Dr. Baternan has still farther illustrat-
ed this idea by remarking, that " the term purpura has been em-
ployed by different writers in so many other acceptations, that some
ambiguity would perhaps have been avoided by discarding it alto-
gether; for some authors have used it as an appellation for measles,
others for scarlet-fever, for miliaria, strophulus, lichen, nettle-rash,
and the petechias (petecchice) of malignant fevers ;" Synops. of Cat.
Diseas. p. 102. While, as he observes, antecedently "the term
purpura was apphed to petechial spots only by Riverius, Diemer-
broeck, Sauvages, Cusson, and some others." It is partly on this
account that the author has employed porphyra instead ot purpura,
as having been less hacknied in medical service ; and partly, be-
cause, as remarked in the Preliminary Dissertation, he has endea-
voured, for the sake of consistency, to derive the names of all the
genera from a common language, and that language the Greek.
To scorbutus there is every objection ; for it is neither Greek nor
Latin, nor any language whatever ; but a term intolerably barba-
rous, derived, as is commonly supposed from the German compound
schar-bocke^ or schar-pocke^ literally uggregate-pox, clnsler-pox^ but
more likely from scharf-pocke, violent or vehement-pox^ or schorf-

212 NOSOLOGY. [CL. III.-OR. lY.

Scorbutus. Boerh. Hoffm, Sauv. et 4uct, Recent.

Scorbutus nauticus. Young.

Scharbocken. — Scorbut. G.

Scorbut. P.

Sea-Scurvy,

GENUS XIII.

EXANGIA.

Enlargement or rupture of a blood-vessel, without external
opening.

Exangeia. Young.

pocke, scurf or seurvy-pox^ to which the inventor has endeavoured to
give a sort of Latin termination. Independently of which scorbutus^
as employed at present, only indicates a particular species of scurvy,
and could not, therefore, without imprecision, be used in a generic
sense.

The subject is well treated in Dr. Bierchen's paper, entitled Mor-
hi Expeditionis Classicte^ in the AmcBuit. Academ. Vol. V. ed. 78. Af-
ter Sir John Pringle, he strongly recommends sour-krout as one of
the most useful acids. Of the mineral acids he chiefly extols the
sulphuric. Dr. Young, p. 229, observes, that in purpura, (land-
scurvy,) " the sulphuric acid is a powerful remedy, the citric inef-
fectual : in true scurvy, (porphyra nautica,) the reverse."

Gen. XIII. ExANGiA. 'E|«eyy/«, frocB s|«tyy/^<», " evacuo e vase."
Hippocr. fhe spontaneous dilatation or rupture of blood-vessels is,
in most instances, the result of local or general debility in the arte-
rial or venous system ; and hence this genus of diseases falls properly
within the scope of the present order. '' We know from daily ex-
perience," observes Mr. B. Rell, " that partial debility frequently
occurs in different parts of the body. Thus there is nothing more
common thnn edematous swellings of the extremities, even in con-
stitutions otherwise healthy ; and swellings of this nature we justly
suppose to depend most frequently on a local v/eakness of the parts
in which they occur. Now why may not a debility of a similar kind
fall upon part of the arterial system ? And if it should ever do so,
we can easily sff^ how, in almost every instance, it must necessarily
terminate in anf^iirismal swellings. — This cause of the disease may
bi' coiisiilered a- the most frequent origin of aneurisms that do not
evidently depend upon external injuries." Surg. I. p. 184. Occa"

CtE. XIU.] NOSOLOGY. 213

1. Aneurisma. Pulsating tumour of an artery.
Aneurisma. Auct.

Abscessus spirituosus. Amat. Lxisitan,'
Aneurism.

« Cysticum. Tumour circumscribed ; formed by a
dilation of the arterial coats within the sphere of
the enlargement.
Encysted Aneurism. BelVs Surg.

Sometimes found in the heart, but less frequently
than in the arch of the aorta. See Baillie Morb.
Anat. F. v. pi. 3, fig. 1 and 2. The aneurismal ar-
tery is, in this case, usually more or less ossified. Id.
PI. 4, fig. 2.
C Dilfusum. Tumour diffuse: formed by the flow of
arterial blood into a subcutaneous cavity, in conse-.
quence of a rupture of the coats of the artery.
Diffused Aneurism. Bell.
7 Varicosum. Tumour protracted : pulsating through
a superincumbent and dilated vein from an injury
common to both.

sionally, however, the debility extends through the whole arterial
system, in which case the coats are not only unusually but irregu-
larly weak, so as to be peculiarly liable to a morbid dilatation or
rupture in every part : and it is to this predisposition that patholo-
gists have given the name of the aneurismal diathesis.

The same observation applies to the veins : though it must be
observed, in respect to both systems, that although this peculiar
diathesis may be an adequate cause of itself, yet, in general, it only
lays a foundation ; and the disease owes its immediate origin to
some co-operating and local power, as pressure, violent concussion,
strain, or other injury. Perhaps the varicose aneurism, as it has
been named by Dr. Hunter, is seldom produced except by the lan-
cet. It appears, however, to be the least dangerous of any, and
the most susceptive of a natural cure. See, for various cases of
natural cure or palliation, Lond. Med. Obs. Vol. II. art. xxxvi. and
Vol. III. art. xiii. See also BeWs Surg. Vol. I. p. 217, 218.

1. «. jE. Aneurisma Cysticum. See two interesting cases of this
variety of aneurism in the carotid arteries by Mr. A. Cooper, Medico
Chir. Trans. Vol. I., in which the operation was performed : unsuc-
cessfully in the first from the long standing and size of the sac,
which pressed with perpetual irritation on the larynx and pharynx,
exciting frequent fits of cough, and preventing deglutition ; success-
fully in the second, in which the tumour was smaller, and of more
cecent date.

214 NOSOLOGY. [cL. Ill.-OR. IV.

Varicose Aneurism, W. Hunter. '
5 Cardiogmus. Obtuse intumescence and constant dis-
quiet of the praRcordia ; with a sense of internal
weight and pulsation increased on the smallest mo-
tion.
Cardiogmus. Galen. Sauv. Vog. Sag.
Cardiogmus. Cull. Catal. Morb. omiss.
Aneurisma praecordiorum. Auct. Far.
Polypus cordis. Auct. Alior.
2. Varix. Soft, livid tumour of a vein.
Cirsus. (K<{o-es.) Auct. Grcec.
Varix. Auct. Lat. et Neoter,

The varix is said at times to burst spontaneously ; in
which case this species would afford two varieties of
the same nature as the first two of the preceding.

GENUS XIV.

GANGR^NA.

The death of a portion of the body, while the rest continues
alive, — often in a sound state.

Gangraena. Gal. et Auct. Recentior.
Gangrene.

Gen. XIV. Gangra;na. r«yyg«<vfls, from y^xim^ " depascor." The
terms sphacelus and gangraina have been employed, both by Greek
and Latin writers, sometimes in a similar and sometimes in a differ-
ent sense ; and where the sense has been different, each term has
at times expressed a higher and at times a lower degree of the
same affection. Generally speaking, however, sphacelus (o-ipotKeAaj,
from o<f>tx^a, " macto,") has expressed the utmost range of a gan-
grene, the total death or mortification of a gangrenous organ : and
we, hence, see how necrosis may be called, as it generally is, a
gangrene, though it has never been termed a sphacelus. In the
present use of the words the author has adhered to this general
view; and has hence taken gangrama for the generic term, under
which the other two will readily range as specilic names. Yet it is
a singular circumstance tliat the most forcible word of the three,
necrosis [yuc^aa-n, from yMg«, interimo, murtifico,) and consequently
best adapted to express utter death or mortification, should, by an

6E. XIV.] NOSOLOGY. 215

1. Sphacelus. The dead part soft, moist, corrupt, and highly

offensive.
Sphacelus. Sauv. Linn. Vog.
Khure. Of Persian origin.
ErLodtung. G.
Gangrene humide. F.
Mortification.
«. Indiictus. Preceded by fever, inflammation, locai

violence, or other exhausting power.
S Atonicus. The result of old age or other debility.

2. Necrosis. The dead part dry, shrivelled, hard and dusky.

Kribelkrankheit. G.

Gangrene seche. F.

Dry Gangrene.

X Albidat Retaining the natural colour of the flesh.

Wliite Gangrene.
S Discolor. The natural colour changed to livid or a
mixture of hues.

3. Caries. The dead part originating in, or extending to, a

portion of the subjacent bone.
Caries, jiuct.

Remmet. Arab, Hence Ozami remime, literally Ossa
cariosa.

4. UsTiLAGiNEA. Gangrene dry, diffuse, divergent ; commenc-

ing in the extremities without fever or intu-

almost unanimous consent, be limited to denote the lowest degree
of a gangrenous aflection : — that mere shrivelling and withering
away of a limb for want of nutriment, which we occasionally meet
with in paralytic patients, extreme old age, or after a severe wound
or an obstinate and sinuous ulcer; in which the substance of the
muscles and integuments is almost entirely absorbed and carried off,
and the bone appears to have scarcely any other covering than the
skin. The French Medical Society have well described it as fol-
lows : La Gangrene seche est caracterisee par la mortification de
quelques unes des extremites, et quelquefoisde toutes. Le membre
s'engourdit, devient doloureux, et eprouve un sentiment de froid,
on plus souvent d'une ardeur insupportable. Le vaisseux s'obliter-
ent, Ics chairs se nourissent, se durcissent, la gangrene p^netre
:;usqu' aux OS, et le malade aux prises avec la mort, est encore
heureux; si la partie gangrenee se separant d'ellemerae, il survit a
la perte de ses extremites. Sac. de Med. 1776.

4. G. ustilaginea. Grain poisoned by the introduction of vegeta-
ble funguses, or other parasitic plants, into the stems or spikelets,
has been often found- when taken as food, productive of the worst

216 NOSOLOGY. [CL. III.-OR. IV.

mescence, and spreading till various limbs
drop off in succession : great hebetude of
mind and body ; often with violent spasms.

Necrosis ustilaginea. Sauv»

Ergot. F.

J^ildew-Mortification,

GENUS XV.
ULCUS.

A purulent or ichorous sore produced by the separation of
a dead part.

Elcus (Iako«.) .^uct. Grac,
Ulcus, jiuct, Lat,
Kerb. Arab.
Geschwar. G.
Ulcere. F,
Ulcer,

and most fatal diseases. The subject has not been sufficiently ex-
amined into, but there are two dreadful disorders, more especially,
to which this cause, under different circumstances, has occasionally
given rise ; both which are denominated by the French Ergot, in
consequence of this term importing blight or mildew : as they are,
also, mal des ardens, from the burning internal heat which is often
felt in either case. The one of these disorders is a typhous fever,
with the general character of pestis, or what Sauvages calls erysi-
pelas pestilens, which is synonymous with the third variety of pestis
under the present arrangement. The other is a tendency, without
fever, to an universal mortification, which commences in the hands
or feet with a sense of numbness and external coldness, a dusky or
livid cuticle, great debility of mind and body, often violent spasmo-
dic contractions; and spreads rapidly over the system, till the
fingers, arms, nose, legs or thighs, are affected, and some of them
drop off spontaneously.

See Phil. Trans. Vol. IV. year 1765; Tissot's Letter to Sir
George Baker. Hist, de VAcad R. des Sciences, 1740, 1748, 1752.
Acta Lipsice, 1708, a Langio, 1752, p. 634. Mezerai Hist, de France,
unn. lO'JO.

Beriberia is perhaps an effect of a similar cause.

(\r.\. XV, Ui.cj's. '£A«fl?, <lerived by Eustathius from tM*, traho^

GE. XV.] IfOSOLOGY. 2l7

1. iNCARNANS, Healthy, purulent, and granulating,

2. viTiosuM. With a vitiated surface and secretion.

« Callosum. The edges indurated and retracted.
, C Spongiosum. With fungous or spongy excrescences,
y Cancrosum. With a hard, livid, lancinating, irre-
gular, fetid, and frequently bleeding tumour at its
base.
Aukile. Arab.

3. siNuosuM. Communicating with the neighbouring parts by

one or more winding channels.
a, Recens. The channel fresh, and yielding,
w Fistulosum. The channel indurated, and of longer
standing.

as though distraho, hereby producing a Xvffii o■u»e;^JS««5, or in the
phrase of modern times, which is a literal rendering of the Greek,
" solution of continuity." Ulcus is therefore, strictly speaking, a
Greek term with a mere change of one convertible vowel for
another. That the genus is rightly placed in the present order,
characterized by a " morbid state of the blood or blood-vessels,
alone or connected with u morbid state of other fluids, producing a
diseased habit,'' will, probably, be granted by every one who
admits the propriety (of which there can be little doubt) of intro-
ducing the preceding genus into the same division. For so closely
is ulcer connected with gangrene, that it cannot exist without it ;
it is its natural effect and sequel, provided the gangrene itself does
not prove fatal.

ulcers are a disease as common to the vegetable as to the animal
world. They are sometimes produced by neglected incisions or
other wounds, and often generated by some local acrimony or other
morbid affection of the fluids ; the secretion being at times highly
virulent, and of a cancerous character; corroding to a considerable
extent the bark, alburnum, and even the pith of the affected tree.
In all these cases the dead parts and thickened edges of the ulcer
should be removed by excision, and the wound, hereby made, be
covered with grafting wax, or, which will often succeed better,
with Forsyth's warm cement. The same disease sometimes attacks
the bulbs of hyacinths, and fleshy roots of other plants, which
should be carefully treated in the same manner ; though, as the
erosion in these cases generally extends in a short time to the
centre, it is not often that we can expect to be successful.

2. y U. vitiosum Cancrosum. Much benefit has been said to be de-
rived in some cases from the application of carbonic acid gass kept
constantly in contact with open cancerous ulcers of the breast.
Dr. Ewart, of Bath, has published two interesting cases, in which
we are told that they healed under this treatment like common
28

218 XOSOLOGY. [CL. III.-OR. IV.

4. TUBERCULosuM, With tubcrculous excrescences, lobed by

ragged and spreading ulcerations : chief-
ly about the ala3 of the nostrils.

Cancer tlupus. Sauv,

Lupus. Willan.

J^oli me tanoerc.

5. CARiosuM. The ulcer extending into the substance of the

subjacent bone.
Caries. Sauv. Linn. Vog. Cull.

If the ulceration extends to the medulla, it is often
called " arthrocace."

The one or the other species found also, occasionally,
as a symptom, in lues, struma, porphyra, and other de-
pravities of the constitution.

ulcers. Dr. Darwin properly ascribes this benefit rather to the
exclusion of oxygen than to any specific virtue in the carbonic acid.
As in common ulcers, the matter does not induce hectic fever till
it has been exposed to the air, and then probably united with
oxygen. The manner of applying the fixed air is by including the
cancer in one half, or hemisphere of a large bladder ; the edges
being made to adhere to the skin by adhesive plaster. Perhaps a
mi.xture of one part of honey with about twenty parts of carpenter's
glue might better suit some tender skins. The bladder is then kept
constantly filled with carbonic acid gass by means of a pipe in the
neck of it ; and the matter let out at a small aperture beneath.
Charcoal powder daily applied, and perpetual exclusion of the air
by the covering of a double oiled silk, have also been advised, with
the same intention as the use of carbonic acid gass, and in many
instances with apparent success.

CLASS IV,
NEUROTICA.

JQISEASES OF THE NERVOUS FUNCTION.

ORDER I.

PHRENICA.

AFFECTING THE INTELLECT.

Error, perversion, or debility of one or more of the mentnr4
faculties.

OENUS L
ECPHRONIA.

Diseased perception, with little disturbance of the judgment,

Cl. IV. Neurotica. Niv^ortxct : " ad nervos pertinentia," from
vu^goy, " nervus." The word here employed is that in general use :
but »evg«« would perhaps be preferable.

Ord. L Phrenica. <Pfsvixct^ " ad mentem spectantia :" from f^nn,
mens. The order is nearly synonymous with the Deliria of Sau-
vages, the Mentales of Linneus, the Paranoias of Vogel, the Vesaniae
of Cullen, and the Alienation mentale of Pinel.

Gen. I. EcPHRONiA. Ex^^mri, or ix.9^67vn '■ from iK<p^a)i^ " extra
mentem," Suidas. So tft(l>^vv., is " mentis compos." It is here used ;
as among the Greeks, generically alone, in the sense of insanity,
and is designed to include melancholia and mania, which by the
older nosologists are rendered, though very improperly, distinct

220 NOSOLOGY. [CL. IV. -OR. I.

occasionally shifting into diseased judgment, with little
disturbance of the perception ; diminished sensibility; irre-
gular remissions.

Deliria. Sauv. CI. viii. Ord. iii,
Vesaniae. Cull. Class II. Ord. IV.
Delirium. Cricht,
Vesania. Parr.
Sufr. Arab.
Unsinnigkeit. G.
Folic. F.
Insanity. Crazintss.
1. Melancholia. The discrepancy between the perception
and the judgment, limited to a single ob-
ject, or train of ideas ; for the most part
with taciturnity, love of solitude, gloomy
fear or suspicion.
Melancholia. Sauv. Boerh. Cull. Pinel.
Mania melancholica. Cricht. Synopt. Tab.
Mania Melancholia. Young.
Suda. Arab.
Schwermuth. G.
Melancholic; ou Delire exclusif. Pinel ii. § 162.

Edit. 2.
Melancholy.

genera, instead of distinct species of one common genus. Even
Cullen has fallen into Ihis perplexed arrangement. Crichton, Parr,
Young, Pinel, and most of the recent German writers, are free
from it. Parr, indeed, in his article Mania, asserts that both con-
stitute nothing more than varieties of one common species ; yet with
an inconsistency which is too frequently to be met with in his Dic-
tionary, he changes his opinion in the article Nosology, makes
Vesania the genus, and arranges melanchoHa, mania, and even
oneirodynia as separate species under it.

The distinguishing characters are clear. In melancholy, the
alienation is restrained to a single object or train of ideas ; in mad-
ness it is general, hi this the nosologists are agreed ; and it hence
follows that gloom, gaiety, and mischievousness, may equally exist
under both species ; according as these propensities are limited to
a single purpose, or are unconfined and extend to every thing. It
is here Dr. Crichton is incorrect ; for he distinguishes the two, nol
by the limitation or generalization of the delirium, but by the rav-
ing or incoherent clamour and violence of the one, and the dejec-
tion or despondency of the other ; which is the vulgar but errone-
ous line of distinction.

GE. I.] NOSOLOGY. 221

A ttonita. Fixt, mute, immoveable melancholy.
Melancolia attonita. Bellini. Sanv.
6 Errabunda. Roving, restless melancholy : having a

constant desire to change the abode,
y Malevolens. Morose or mischievous melancholy :
occasionally terminating in suicide or the injury of
others.
3 Complacens. Self-complacent and affable melancho-
ly ; occasionally rejoicing in a visionary superiori-
ty of rank, station, or endowments.
Melancholia Moria. Nenter. Sauv.

See, for examples, Hor. Sat. iv. Ep. ii. 2. But of
this modification one of the best examples that has
ever been drawn, is that of Don Quixote, taken un-
questionably from real life. This variety is con-
nected with all the rest in the leading specific cha-
racter of the discrepancy between the perception
and the judgment being limited to a single object
or train of ideas ; but it differs from them by the
intermixture of a certain degree of eparsis, or senti-
mental elevation, which destroys the common ten-
dency to taciturnity, solitude, and gloomy appre-
hension. •

The more common causes of the disease as a
species are false views of religion ; severe disap-
pointment; longing after one's native country and
friends : continued grief.
2, Mania. The discrepancy between the perception and the
judgment general; raving; entony ; andempas-
sioned emotion.

There seems to be an equal incorrectness, though of a different
kind, in M. Pinel, whose book is nevertheless of great merit. De-
lirium, or wandering, is a pathognomic symptom in both species ; a
want of correspondence between the judgment and the perception,
which is what Dr. Cullen means by the term insania. M. Pinel,
however, has offered instances of what he calls mania without any
such discrepancy ; and he has hence estabUshed a species which he
denominates manie sans delire. These instances, however, are all
reducible to examples of rage or ungovernable passion ; and ought
by no means to be confounded with mania ; the judgment being in
this last, not at variance with tlie perception, but overpowered by
the predominant fury or passion of the moment. Ail these belong
properly to the next genus.

222 NOSOLOGY. [cL. IV.-OR. I.

Mania. Boerh. Sauv. Linn. Cull. Pintl.

Delirium maniacum. Hoffm.

Delirium Mania. Cricht,

Mania universalis. Young.

Vesania Mania. Parr.

Jenun, Mejnunlyk. Turk,

Tollheit. G.

Manie. F,

Madness.

» F^rox. Furious and violent madness.

Mania ferox. Cricht.

Manic avee delire. Find i. § 157. Edit. 2.

Cured in one instance by an abscess in tlie hand.
Act. Nat. Cur. viii. Obs. 102.
C f^xiiltans. Gay and elevated madness.

Mania mitis. Cricht. ii. 342. Paraphrosyne, id.
Synopt. Tab.
y Despondens. Gloomy, despondent madness.

Mania melancholica. Cricht. Symp. Tab.

The despondent cases are more dangerous than

those of hilarity.
J Demens. Chaotic madness.

Dementia. Sauv.

Demence. Pinel. iii. § 171.

2. 3 E. Mania Demens. In this variety there is an utter incohe-
rance of ideas, and evanescence of external impressions. The un-
happy subject speaks rapidly with unmeaning babble, of daggers,
dismasted ships, green meadows, his wife, his wig, the minister or
commander in chief; looks with a threatening aspect, which he in-
stantly exchanges for a wild and horrible laugh, and then sinks into
a momentary calm.

Pinel has admirably characterised it in the following definition :
" Rapid succession, or uninterrupted alternation, of insulated ideas,
and evanescent and unconnected emotions : continually repeated
acts of extravagance : complete forgetfulness of every previous
state : diminished sensibihty to external impressions : abolition of
the faculty of judgment : perpetual activity, without object or de-
sign, or any internal sense of its taking place.*' De VAlicn. Menl.
Sect. III. iii. § 176.

Gen. II. Empathf.ma. Tlxin^x, whence ift7rct6tii^ " cui insunt affectus
seu perturbationes : adoctti pi rcitus, vel commotus." T« fciv n T*)f
"^^X^.i wfflrv x«« MytKif to Ss «A«y«» K»t iwrccini- Pint. adv. Col.

GE. II.J NOSOLOGY. 223

GENUS II.

EMPATHEMA.

The judgment perverted or overpowered by the force of
some predominant passion : the features of the counte-
nance changed from their common character.

Mania a pathemate. Sauv.

Manie sans delire. Pind. i. § 159.

Ungovernable Passion.

1. ENTONicuM. The predominant passion accompanied with in-

creased excitement, ardour and activity: eye
quick and daring ; countenance flushed and
tumid.
« Iracundiae. Wrath.

Ira furor brevis est. Hor. Ep. i. ii.
S Superbiae. Pride.
y Gloriae famis. Ambition,

Doximania (A«|<|te«y««.) Auct, Grcec.
3 Letitiffi. Joy. Transport.
E Philautiffi. Self-love. Self-conceit.

Amor sui. Darzc
^ Zelotypiae. Jealousy.

2. AToNicuM. The predominant passion accompanied with di^-

minished excitement, anxiety, and love of so-

This species has never hitherto been properly digested ; and it is
singular that Dr. Crichton, who has written so excellently on the
diseases of the passions, and has illustrated his observations with
such a variety of examples, should, both in his " Inquiry into the
Nature of Mental Derangement," and in his ••' Synoptical Table,"
either have assigned no place to these diseases, or have transferred
ihem to delirium (ecphronia;) although the perception and the
judgment are for the most part strikingly clear, and often peculiarly
acute. In this last case, indeed, it is frequently perverted by the
prevailing emotion or passion of the moment, as where a man, un-
der the influence of despair, reasons himself into the lawfulness
and expediency of suicide ; but the argument, though perverse, is
connected and well sustained, of which we have had various exam-
ples in the philosophical suicides of Germany, hi the greater num-

224 NOSOLOGY. [CL. IV.-OR. I.

litude ; eye fixt and pensive ; countenance
pale and furrowed.
a, Desiderii. ' Longing. Eager desire for an absent ob-
ject, whether place or person : and hence equally
inclu>^mg home-sickness, country-sickness, love-
sickness.
Erotomania (^EforofMnx,) Auct. Grcsc.
Amor insanus. Sennerti,
Melancholia amatoria. Sauv*
» Auri famis. Avarice.

Chrysomania (Xfvatf^uux ) Auct. Grac.
y Anxietudinis. Preying care.

Melancholia phrontis. Hippocr. Sauv.
.. i.. Curae gravis morbus. Fcesii^ p. 486.

Maladie soucy. Le Clerc. Hist, de Med.
S Moeroris. Heart-ache. Severe grief.

Gasavet. Arab.
^ Desperationis. Despondency.

It would occupy too much space to follow up all
the varieties in either species ; many of which are
compound emotions, produced by an union of diife-
rent, sometimes of opposite, passions.

ber of cases, however, the judgment, instead of being' perverted, is
merely overpowered by the empassioned emotion ; there is neither
false judgment nor false perception.

The elegant and fanciful mind of the Greeks distinguished ever}'
violent or over-ruling passion by the name of mania, and hence
doximania, erotomania, chrysomania ; and the same word is com-
monly used in the same sense in the colloquial language of our own
day. For general or poetical use the term is intelligible enough :
but it is not sufficiently correct for medical or physiological pur-
poses, in which predominant passion must necessarily be distinguish-
ed from delirium.

Gen. III. Alusia. Aauj. xhvcjtf, ccXvfffcci^ " oberratio.'' Galen
occasionally employs the second. The theme is aXva^ " errabunda
mente afficior; inqnietus oberro :"" whence the Latin alhtcinado.,
and hullucinatio. The Greek term is preferred to the Latin, for the
sake of uniformity, in fixing the generic names. Sauvages, and af-
ter him Sagar, have employed hallucinatio as the name of an order,
including various diseases that have little connexion with each other.
Darwin and Crichton have used it as it here stands, in a generic
sense. In whatever meaning employed, hypochondrias or hypo-
chondriasis is usually placed under it. It is so by Sauvages, Sagar,
and t Tichlon ; and it occupies the same place in Linndus, who has
merely adopted the term imaginarii instead of hallucinationcs. la

«JE, III.] NOSOLOGY. 225

By long continuance, or frequent and habitual in-
dulgence, most of them have occasionally been found
to terminate in ecphronia or insanity. See Eph. J^aU
Cur, passim. ; and Plater. Observ.Jib. i, who gives
instances from most of the passions.

GENUS III.
ALUSIA.

*rhe judgment perverted or overpowered by the iorce of
the imagination ; the spirits permanently elevated or
depressed ; the feelings of the mind depicted in the
countenance.
Hallucinatio. Cricht. Darw,
Sehu. Arab,
Illusion.
1. ELATio. Romantic ideas of real life; ardent and exalted
fancy ; pleasurable feelings ; frequent pulse ;
great activity ; eye keen and lighted up : coun-
tenance confident and animated.

Pinel the disease seems to be included under alienation mentale^ and
its different varieties to be distributed, though without particular re-
mark, amidst the five species into which he has divided this affec-
tion. But in hypochondrias, and indeed in alusia in general, there
is no morbid or false perception, or mistake of surrounding objects,
the judgment being only led astray by the imagination. So little
indeed has hypochondrias to do with real insanity, {ecphronia,) that
Vogel, CuUen, Young, and many other celebrated nosologists, have
placed it in the list of corporeal instead of in that of mental diseases ;
the first enumerating it under the order of Spasmi, the second under
that of Adynamiae ; and the third making it a species of dyspepsia j
which, however, is to wander no less from the mark ; for the pa-
thognomic symptoms are of a mental character, though corporeal
affections are perhaps always united with them.

For the merit or demerit of the first species here named from
the rhetoricians, elatio, the author suspects he must be alone answer-
able, and throws himself on the reader's candour for its introduc-
tion. It is however strictly derived from nature, and intended to fill
up what has hitherto been left as a vacant niche by the nosologists.
Alusia, or hallucinatio, like ecphronia, or insanity, comprises a list
29

226 NOSOLOGY. [CL. IV.-OR. I.

Smtimmtalism.

Mental extravagance,

* Heroica. Chivalry. Romantic gallantry.

A generous and high-spirited flight of the imagina-
tion, but now grown obsolete, and rarely to be met
with except in ancient tales and traditions. Like un-
governable passion, (empathema,) it may lead to, and
be combined with ecphronia, or insanity, as in the
case of the exquisite fiction of the knight of La Man-
cha already adverted to.

of affections that are characterised by two opposite states of ner-
vous action, entonic and atonic ; elatio is intended to include the for-
mer of these, as hypocondrias is the latter. They stand in the
same relation to each other, as elevated and dejected madness or
melancholy. Both are united with a peculiar modification of the
digestive function, but possessing opposite bearings ; being in the
former strikingly active and energetic, and in the latter strikingly
sluggish and languid. Hence under the first species the patient is
able to endure enormous fastings, and to support life upon the scan-
tiest and least nutritive diet, either of which would be destructive
under the second. The physiologist may readily pursue this sub-
ject, and find additional reasons for the present collocation ; but this
is not the place for physiological speculations ; though they may be
indulged perhaps in a future work upon pathology and physiology.
See an elegant essay ou this subject in JYicholsoii^s Journal, vol. xv.
art. vii. p. 288.

2. Alusia Hypochondrias. The specific name is taken from the
anatomical term v7rox,»v^^t«, in which the disease was formerly sup-
posed to be seated. Hypochondrias is here used instead of hypo-
chondriasis, because, as already observed on various occasions, the
terminal iasis is, with very few exceptions, limited to a peculiar fa-
mily of cutaneous diseases. See the Preliminary Dissertation, and
Table of Definitions. The author has felt the less difficulty in mak-
ing the present change, as hypochondriasis is of comparatively mo-
dern invention, and is not to be met with either in the Greek or Latin
writers, by whom the complaint is usually alluded to or described as
a species of melancholia, or rather a disease of the melancholic
temperament. It constitutes the third sort or species of this malady
as described by Galen, and which he attributes to a pecuhar affec-
tion of the stomach. His words are these : " Est preeterea tertium
melancholiae genus, morbi coniitiaiis exemplo, ciim ortum a ventri-
culo habuerit : solentque medicorum aliqui hatic dispositionem,/«wo-
chondriacum, flatuosum qui morbiim, nominare." De Loc. Affect.
lib. iii. cap. G. Diodes, a physician of great reputation, had not
long before published a treatise on the diseases of the stomach, in

GE. m.] NOSOLOGY. .227

C Facetosa. High spirits ; sparkling ebullient wit, in-
capable of restraining itself; that often sacrifices a
friend at the shrine of a jest.
y Ecstatica. False inspiration ; visionary conceits.

The judgment urged to mistake energetic ideas for
realities; to believe in phantasms; in an immediate
communication with spirits, or in the power of work-
ing miracles. Examples may be found in all ages,
and in all religions. One of the most interesting is
that of Saint Teresa in Butler's Lives. In our own
day one of the most striking is that of Baron Sweden-
borg. This morbid aiflatus is often aped by cunning
impostors to serve their own interest with the multi-
tude.

Hallucinatio Dasmonomania. Cricht.
3 P'anatica. Fanaticism. Religious flights of the ima-
gination predominant over the natural feelings as well
as the judgment; urging to a voluntary and uncal-
led for submission to severe privations, mortifi-
cations, and torture; or to the torture and mas-
sacre of those who profess different creeds. Exam-
ples, as in the last variety, may be found in every age
and religion : among the prophets of Baal, 1 Kings
xviii. 28 ; the Curetes or Phrygian priests, Lucret. ii,
631 ; the fanatical votaries of the Indian Jugger-
naut ; in many of the convents and nunneries of La-
mism, especially at Thibet, and still more so in many
•catholic countries: in the fanatical promoters of
the sufferings of the Waldenses, the furies of St. Bar-
tholomew's day, and the fires of Smithfield.
Daemonomania fanatica. Sauv.
Kefijet. Arab.
2. Hypochondrias. Gloomy ideas of real life ; dejected spirits ;
anxiety ; dyspepsy ; languid pulse ; in-
disposition to activity ; eye oblique and
scowling; countenance gloomy and sul-
len.

which this "malady occurs as one of them. Galen adverts to this
publication, thinks the disease improperly placed in such an arrange-
ment, and regards the symptoms enumerated by Diodes as for the
most part accidental occurrences. " Verum satis mihi fuerit, ea ac'
cidentia percurrere, quae a Diocle praescripta sint in libro cui titulus
sit Affectio, Causa, Curatio,^'' &c.

2. n A. Hypochondrias, Autalgica. To this variety belong the sy-

228 NOSOLOGY. [CL. IV.-OR. t

Hypochondriasis. Auct. Recent.
Morbus hypochondriacus. Frascast. Boerh.
Malum hypochondriacum. Galen. Hoffm. JuncL
Hallucinatio Hypochondriasis. Cricht.
Dyspepsia Hypochondriasis. Young,
Ghemm. Arab,
Ghem. Pers.
Traurigkeit. G.
Hypochondrie. F.
Hypochondrism.
Low spirits,

M, Autalgica. With visionary or exaggerated sense of
pains, or disease ; whimsical dislike of persons,
places, or things 5 groundless apprehensions of per-
sonal danger, or poverty.
Melancholia asgrorum imaginariorum. F. Chxchointau.
Melancholia argentis. Sauv.
Grillenkopfheit. G,
Maladie imaginaire. F.

See for an example drawn from the life, Moliere's
celebrated comedy.
Vapours,
C Pertaesa. With general listlessness, or disgust ; irk-
someness and weariness of life.
Melancholia Anglica. Sauv.

Taedium vitae. Darw. who gives various examples,
vol. iv. p. 90, 8vo. ed. ; as does also Sauvages, who
particularly refers to GresseCs comedy,' entitled
Sydney. See also Lucr, iii. 1074.
Melalet. Arab.
Verdriisslichkeit. G.

philis imaginaria, psora imaginaria, and tabes imaginaria of Darwin ;
the diseases perhaps to which the hallucination is chiefly directed, and
on which it principally feeds. The author has at this moment under
his care a singular case of the first. Mr. S. is a man of excellent cha-
racter, aged forty-six : he has for some time been engaged to a lady,
whom he forbears to marry merely from a morbid apprehension that
he has so debilitated his frame, by having indulged in illicit amours at
an early period of life as to be totally unworthy of her virtues and
affection ; and that his union with her would prove her ruin. In
every other respect he is perfectly well; yet irresistibly impressed
with this miserable fancy, he is full of wretchedness, gets no sleep at
night, indulges in silence and solitude, and has be^n often tempted to
pommit suicide.

GE. IV.] NOSOLOGY. 229

Ennuie. F,

Weariness of life. Spleen.
y Misanthropica. With general malevolence, peevish-
ness, and abhorrence of mankind.
Menschen-feindschafft. G.
Misanthropie. F.
Misanthropy,

GENUS IV.

* APHELXIA.

Voluntary inactivity of the whole or the greater part of
the external senses to the impressions of surrounding
objects, during wakefulness.
Nachdenckenkeit. G.

Gen. IV. Aphelxia. 'A(p£>i|<a, from et<f)s^icu, " abstraho," " re-
traho," " avoco," " abduco." So Xenophon De Volupt. K<pi^Kovr» .
7rg«s ra nhx. The subject is almost, if not altogether new to noso-
logy, and has seldom been dipt into by physiologists. Darwin occa-
sionally touches upon it in different parts of his Zoonomia, and Dr,
Crichton in his Inquiry into the nature of mental derangement ; but
it yet remains to be analyzed and reduced to a nosological method.

In order to become acquainted with the existence of surrounding
objects, or of an external world, as it is called by psychologists,
three things are necessary ; sound external senses ; a secretion of
the nervous material, whereby they are made capable of being sti-
mulated by the objects addressed to them ; and an exercise of the
faculty of attention to the impressions which are thus produced.
The will has the power of calling this, as it has, or ought to have,
of calhng every other faculty of the mind into a state of exertion,
or of allow. ig it to be indolent; and it is chiefly upon an assent of
the will, to t! relaxation of the attention, or to its concentration upon
some object unconnected with those immediately before us, that the
phaenomenon of revery depends. In reading books in which we are
totally uninterested, composed in a tedious and repulsive style, we
are almost continually in a state of revery. The will does not ex-
ert its power ; the attention is saffered to wander to something of
stronger attraction ; or the imagination is left to the play of its own
capricious ideas ; and though we continue to read, we have not the
smallest knowledge of the argument before us ; and if the subject
to which the train of our thoughts is really directed be of a strik-

230 NOSOLOGY. [CL. IV.-OR. I.

Reverie. F.

. Revery.
1. socoRS. ■ Truant. attention; wandering fancy ; vacant or va-
cilling countenance.
Absence of mind.

An absence or vacuity too common at schools and at
church ; over tasks and sermons.

ingly ludicrous character, we may possibly burst into a laugh in the
middle of a discourse of great gravity and seriousness, to the asto-
nishment of those around us. It is of high importance therefore
that the will should obtain a perfect command over the attention;
and it should be one of the first efforts of practical education to
Strengthen it in the exercise of this power. Nothing indeed can
ever be learnt or seriously engaged in without it. Yet it is often most
culpably neglected ; and an habitual inattention to every thing that
ought to engage our notice whether in the world without us or the
world within us, is the necessary result, and lays a foundation for
some of the most awkward and ludicrous reveries or absences of
mind that are to be met with. It is this description of revery that
constitutes our first species.

There is another of a more grave and allowable kind, and which
forms a direct counterpart to the preceding. It occurs in cases of
intense application of all the powers of the mind to a particular
subject; as, for example, of pure mathematics, or some overwhelm-
ing passion. In this state, the attention, instead of being indolent,
is, with the consent and by the direction of the will, so completely
absorbed and abstracted by the subject in question, that it is with
great difficulty it can be roused by any stimuli whatever to bend
itself to any thing else ; and consequently the person who is thus
abstracted, is torpid to the world around him ; he hears nothing, he
sees nothing, he feels nothing; while the external senses themselves
are, perhaps, still further blunted by having the whole stock of ner-
vous or sensorial fluid exhausted, so to speak, at a single outlet in
support of the prevailing ecstasy. It is this which constitutes the
second species of revery here offered. The fall of Archimedes af-
fords us a striking example of it. When the Roman army had at
length taken Syracuse by stratagem, which the tactics of this won-
derful man prevented them from taking by force : he was shut up
in his closet, and so intent on a geometrical demonstration, that he
was equally insensible to the shouts of the victors, and the outcries
of the vanquished. He was calmly drawing the lines of a diagram,
when a soldier abruptly entered his room, and held a sword to his
throat. " Hold friend, said Archimedes, one moment, and my de-
monstration will be finished." The soldier surprised at his uncon-
cern at a time of such extreme peril, resolved to carry him before

OE. IV.] NOSOLOGY* 231

2. lUTTENTA. The attention wound up, and rivetted to a particu-
lar sul)ject ; with sympathetic, emotion of the
muscles and features connected with its general
drift.
Tiessinnigkeit. G.
Abstraction of mind.
*i A studio. From intense study.
C A pathemate. From overwhelming passion : as rap-
ture, grief, despair.

Marcellus ; but as the philosopher put under his arm a small box
full of spheres, dials, and other instruments, the soldier, conceiving
the box to be filled with gold, could not resist the temptation, and
killed him on the spot.

1 here is a third species of revery, which diflFers widely from
both the preceding. The attention is equally summoned into action,
and dismissed at the command of the will. It is summoned in the
last species; it is dismissed when a man voluntarily surrenders him-
self to ease and listlessness of mind: during which period, more-
over, in consequence of this indulgence in general indolence, the
external senses themselves unite in the mental quiescence ; and a
smaller portion of nervous material is probably secreted for the
very reason that a smaller portion is demanded ; and hence the ex-
ternal senses are as torpid as the internal, and as little susceptible
to their respective stimuli. The first playful ideas that float over
the fancy m this case take the lead, and the mind relaxes itself with
their easy and sportive flow. This is denominated brown study,
listless musing; it forms the last species of revery in the present
genus, and is thus admirably described by Cowper in his Task, B. IV.

Laugh ye who boast your more mercurial powers,

That never feel a stupor, know no pause,

Nor need one ; 1 am conscious, and confess,

Fearless, a soul that does not always think.

Me, oft, has fancy, ludicrous and wild,

Sooth'd with a waking dream of houses, towers,

Trees, churches, and strange visages, express'd

In the red cinders, while with poring eye

I gaz'd, myself creating what I saw.

Nor less amus'd have I quiescent watch'd

The sooty films that play upon the bars

Pendulous, and foreboding, in the view

Of superstition, prophesying still.

Though still deceiv'd, some stranger's near approach,

•Tis thus the understanding takes repose

In indolent vacuity of thought.

And sleeps, and is refresh'd. Meanwhile the face

232 ' NOSOLOGY. [CL. IV.-OR. I.

3. OTiosA. Leisurely listlessness ; free surrender of the judg-
ment to the sportive vagaries of the fancy ; quies-
cent muscles ; idle gravity of countenance.
Studium inane. Darw.
Brown study. Listless musing.

GENUS \.
PARONIRIA.

The voluntary organs connected with the passing train of
ideas overpowered by the force of the imagination
during dreaming, and involuntarily excited to their
natural or accustomed actions : while the other organs
remain asleep.

Conceals the mood lethargic with a mask

Of deep deliberation, as the man

Were task'd to his full strength, absorb'd and lost.

For an elegant essay on this subject see an article in the Manches-
ter Memoirs, Vol. I, series ii, by the Rev. Johnson Grant, A. B. of
St. John's College, Oxon.

Gen. V. Paroniria. From srag*, and d«/g«». " depraved, disturb-
ed or morbid dreaming." So §t;<rov8<go5, in Dioscor. ii. 127. " tumul-
tuosis et malis somniis molestans."

Under the article Ephialtes, CI. II, ord. ii, gen. 4, the author has
already pointed out his reasons for separating paroniria from this
last disease, notwithstanding that they are united by Dr. Culien
under the common name of oneirodynia. They have, in fact, no
resemblance vvhatever, and scarcely any connexion. All the spe-
cies arranged under paroniria, in the present text, are so palpably
and decidedly of the same family, that it is not necessary to enter
upon the question. They are here, however, associated for the
first time in a genus distinct from ephialtes. See a singular instance
of this affection related in Sir William Forbeis Life of Dr. Beattie.

Gen. VI. MoRiA. Mu^tx, from ft^wga?, "stultus," " fatuus." The
author has limited the term to its proper signification. Vogel em-
ploys it, though with a different termination, (morosis instead of mo-
ria,) in the same or very nearly the same sense ; but he is almost the
only medical writer that does so. His words are, " mentis imminuta
et infirmata functio, seu quaedam ignavia, citra delirium etsoporem."
Moria is used by Nenter and Sauvages to denote melancholia com-
placens^ (self complacent melancholy,) while by others it is employ-

GE. v.]

NOSOLOGY. * 233

Oneirodynia activa. Cull.
Erethismus Onirodynia. .Young.

1. AMBULANS. The musclcs of locomotion excited into their

accustomed action by the force of the imagi-
nation during dreaming.

Somnambulismus. Sauv. Linn. Sag.

Nyctobasis. (NvKroQxffn.) Auct. Grcec.

Noctambulatio. Jnnck.

Schlaf-spatzieren. G.

Sleep-walkmg. Somnambulism,

2. LOQUENS. The muscles of speech excited into their accustom-

ed action by the force of the imagination during
dreaming.
Nyctegersia. (N«xT£y£g««.) Jluct. Grac.
Sleep-talking.
o. SALAX. The sexual organs excited into venereal action by
the force of the imagination during dreaming.
Gonorrhoea oneirogonos. Sauv.
Gonorrhoea dormientium. Cull.

ed synonymously with anoea, or idiotism. To complete the con-
fusion, morosis, (amentia Morosis^) is the name given by Sauvages
to mental imbecility, (moria imbecillis^) though, as already observed,
he has just before used moria in the sense of melancholy. It is
precisely in the signification now offered that the term is employed
by Erasmus, in his celebrated treatise, entitled '' Jlfonce Encomium,''^
or " The Praise of Folly," which he dedicated to Sir Thomas More.

Mora^ moror^ morosus, morositas, are derived from this common
source, and uniformly import " waywardness, tardiness, dulness,
impediment;" though the lexicographers, not having hit upon the
right path, have wandered in different directions without being able
to satisfy themselves. In Sauvages and Sagar morositates are in fact
corporeal moriw, " defects or hebetudes of the bodily functions."

2. Moria demens. This term is preferred to amens, as being
somewhat more general ; though amens, or amentia, like moria, in
the preceding note, has been used, without any authority, in a very
loose and indeterminate signification by medical writers ; among
whom it imports equally, insanity, stupidity, dotage, and idiotism.
The last alone is its direct sense, and the author would have em-
ployed it to denote the variety y, but from its want of a fixt mean-
ing in the present day ; on which account he has preferred thg
Greek univocal term ancea, («>«<«,) from u. priv. and »«a5, or v§vs,
mens: '■'■total destitution of mind.'''' Paranoea, (7r«g«v»»«,) is a more
general term, and is, as nearly as may be, synonymous with demen-
tia. Both import " derangement of mind" in contradistinction to
30

234 NOSOLOGY. [CL. IV.-OR. I.

Exoaeirosis. Cricht.
Ppllutioii involuntaire. F,
Night pollution.

G E N U S VI.

MORIA.

Defect or hebetude of the understanding.
Morosis. Linn. Vog,
Amentia, Sauv, Sag, Cull. Cricht.
Matuhlik, DeUlik. Turk.
Unverstand. G,
Fatuite. F,
Fatuity.
1 . iMBECiLLTS. The defect or hebetude partial or confined to
particular faculties of the understanding.
Amentia Morosis. Sauv.
Schwachheit. G.
Imbecillite. F.
Imbecility.

X Stupiditas. Dulness and indocility of the apprehension ;
torpitude and poverty of the imagination.
Yehem. Arab.
Dummheit. G.
Betise. F.
Stupidity.
C Amnesia. Feebleness or failure of the memory.

Amnesia. Sauv, Sag. Cull. See note of the last under

gen. Ixv.
Oblivio. Ldnn. Vog.
Memoriae debilitas. Junck.

" alienation of intellect," which is ecnoea, or ecphronia, as observed
in a prior note.

2. S M. demens Lerema, (^»)f«^«,) from A)jg8s, " ineptus," is direct-
ly synonymous with dotage^ and is the common technical Greek
term, it is the proper root of de-lirus, (among ancient writers
" delerus,") and delirium.

This order ought not to close without the following note upon the
much agitated question of coercion, added by M. Pinel to the second
edition of his well known treatise on Mental Mienation.

GE. VI.] NOSOLOGY. 235

Recollectionis jactura. Darw»

Dysaesthesia interna. Young* *•.,•

Vergesslichkeit. G. " '• ■

Oubli. F.

■Forgetfulness. Oblivion.

Sometimes arising instantaneously, Salmuth, Cent. 11.

obs. 41. Forgetfulness of the pronunciation of written

words, but with a power of writing them. Ephem, Mat,

Qur» Dec. I. an. iii. obs. 198, and p. 603. An. iv. and

V. obs. 154. Total as to places, or the discrimination

of one place from another, for half an hour, in Mr. J.

Hunter. See Sir Everard Home's Life of him prefixed

to his Treatise on Inflammation, p. Iviii,
y Credulitas. Weakness and undue pliancy of the judg-
ment, with facility of being duped.

Credulitas. Darw.

Leichtglanbigkeit. G,

Credulite. F.

Credulity.
3 Inconstantia. Instability and irresolution of the will.

Leichtsinnigkeit. G.

Inconstance. F.

Fickleness,

Other varieties might be added, but it is unnecessary.
3» DEMENS. Defect or hebetude of all the faculties of the un-
derstanding.

Dementia. Auct. Lat,

Paranoea (nx^tcvtuc.) Auct» Grcec.

Beladet. Arab,

Unvernunfft. G.

Demence. F,

Witlessness. Irrationality ,

K Stultitia. Shallow knowledge ; feeble judgment ; light,
frivolous fancy ; for the most part with good-na-
ture ; sometimes with obstinacy.

Thorheit. G.

Niaiserie. F,

Folly, Silliness,
C Lerema. Impotence of body as well as of mind from
natural or premature old age': childish desires and

J'ai examine avec un soin scrupuleux les effets que produisoit sur
les ali€n€s Tusage des chaines de fer, et ensuite les resultats com-

236 NOSOLOGY. [cL. IV.-OR. I.

pursuits ; drawling speech or garrulous babble, com-
posed of ideas, for the most part associated by pre-
. vious habit.
Lerema (M^v^x.) Auct. Gr<,
Anilitas. Jluct. Lat»
Aberwitz, G.
Radoterie. F.
Dotage. Siiperannualion.

y Anoea. General obliteration of the mental powers and
affections ; paucity or destitution of ideas ; obtuse
sensibility ; vacant countenance ; imperfect or brok-
en articulation ; with, occasionally, transient and
■ v:,;.^ unmeaning gusts of passion.

■' ■ Wahnsinnigkeit. G.

"* Idiotism. F.

Idiotism.

i • ■— * — ■* —

paratifs de leur abolition, et je ne puis plus former des doutes en
laveur d'une repression plus sage et plus moderee. Les memes
alienes qui, reduits aus chaines pendant une longue suite d'annees,
etoient restes dans un etat constant de fureur, se promeooient ensuite
tranquillement avec un simple gilet de force et s'entretenoient avec
tout le monde, tandis qu'auparavant on ne pouvoit en approcher
sans le plus grand danger. Pre/, p. 1.

Order II. iEsTHEXir a. "'AtcrStirux^ from utg-Suvofiaf^ " sentio, et
proprie, sensu corporis," The term applies however to all the
external senses ; and in the language of Galen peculiarly expresses,
» etiffOnriic^ ^vm/nii, " the power or faculty of sensation." At the
same time it must be admitted, that it is occasioually appHed to
mental sensation, as in Isocr. to Demonicus, awrw tjjv ntuvm yyu/^r.v
kt(r6^irni " thus may you/ec/ their mind or incUnation."

It is hence not to be wondered at that the term should be used
in different senses by different medical writers. It has seldom,
indeed, been applied to the mind, but has strangely varied between
expressing sensation generally and the sense of touch alone. Dr.
Young, with his usual correctness, has made use of the term in the-
same sense in which it is adopted in the present system, to indicate
diseased sensation of all the external organs; but he has deviated
from his usual correctness in immediately afterwards applying it to
defective memory^ which he terms dysesthesia interna, and ranks in
the same list or genus, with defect of the external senses.

Sauvages, and after him Sagar and Cullen, have employed dys.es-
THESi^E in the signification of hebetude of the external senses gene-
rally ; synonymously with the privativi of Linneus, and partly so
with the ADVNAMiiE of Vogel ; and having thus made their option of

GE. I.] NOSOLOGY. 237

ORDER II.

iESTHETICA.

AFFECTING THE SENSATION.

Dullness, depravation or abolition of one or more of the ex-
ternal organs of sense.

GENUS L .;•;;•

PAROPSIS.

Sense of sight vitiated or lost.
Dyseesthesia visualis. Young.

the meaning of the term, it became them to adhere to it ; and under
such adherence, ancesthesice must have imported atony or inactivity
of the same senses generally. But while dyscesthesice extends to all
the senses, ancesthesice is by the above writers limited to the single
sense of touch : unquestionably with no small perplexity to the
young student.

Gen. 1. Paropsis. neifo-<l^t?, " diseased vision :" from 7r«p«t, " male,"
and «\|/<s, " visus:" as paracusis from Trctpcc and xkovvi- Dr. Young is
the only English nosologist, the author is acquainted with, who has
endeavoured to arrange all the primary defects of the organ of
vision under one head. With him, however, this head constitutes
a mere species, under the generic term dysoesthesia, which, as
already observed, is made to extend to all the senses. And con-
sequently long-sightedness, and short-sightedness, weak and acute
sight, double-vision, squinting and cataract, are all contemplated as
mere varieties of the same specific disease. This can never be
allowed : the error consists in reducing to a species what ought to
have been a genus, under which all the varieties might have ranked
as separate species belonging to it. Amaurosis ought also to have
ranked under the same banners, though carried by the learned
writer to another class.

In selecting and defining the specific names much confusion has
been exhibited, in consequence of the generic term being under-
stood by some writers in a natural or hteral, and by others in a

238 NOSOLOGY. [CL. IV.-OR. II.

1. LUCiFUGA. Vision painfully acute in a strong light; but

clear and pleasant in a deep shade or the dusk
of the evening.
Nyctalopia. Hippocr. Pradict,
Visus nocturnus. Boerh.
Oxyopia. Auct. Var,
Hemeralopia. Neoter.
Amblyopia meridiana. Sauv,
Photophopia. Plcnck.
Dysopia luminis. Cull.
Visus acrior. Dano,
Tagblindkeit. G.
Nyctalopie. F.
Night-sight.

Chiefly common to those who live almost constantly
in dark inclosures, as mines or prisons ; or who have
recently had a cataract depressed or extracted. Usu-
ally accompanied with perpetual nictitation.

Found also, occasionally, as a symptom in opthalmy,
irritation of the optic nerve, and hydropscapitis. For
the last see Wilt. Von der Hirnwassersucht.

2. NOCTiFUGA. Vision dull and confused in the dusk ; but clear

and powerful in broad daylight.
Hemeralopia. Auct. Grcec. Plenck.
Visus diurnus. Boerh.
, Nyctalopia. Neoter.
Amblyopia crepuscularis. Saxi~c.
Dysopia tenebrarum. Cull.
Shebkeret. Arab.
Nachtblindkeit. G.
Day-sight.

Said to be endemic in many parts of Asia ; and to be
a frequent affection in the Brasils, West Indies, and Po-
land, See Hautsiierck " Recueil d'Observations de Me-
dicine, i. 2. Weiz Ncue Ausziige aus Dissertationen fiir
Wundarzte."

technical or implied sense. Thus nyctalopia, literally night-sight^
was employed by the Greeks agreeably to its literal meaning, to
import that imperfection of vision under which the eye can only tee
at night or in a deep shade : while the same term has been used by
modern writers in the opposite sense of night-sight-acAe, agreeably
to the technical or implied meaning of opia, when employed patho-
logically ; and has hence been made to import day-sight instead ol

GE. 1.] NOSOLOGY. 23D'

Plenck asserts that some men have so strong a day-
sight as to enable them to distinguish the stars at
noon.

3. LONGiNQUA. Vision only accurate when the object is far off.

Amblyopia proximorum. Sauv.

Dysopia proximorum. Cull.

Presbyopia. Plenck.

Weitsichtigkeit. G.

Vue longue. F.

Long-sight.

« Vulgaris. Common to every period of life, and chief-
ly produced by habitual relaxation of the iris,
mostly with somewhat too flat a cornea.

C Paretica. From partial paralysis : as an absolute in-
contractility of the iris, by which the diameter of
the pupil is rendered unchangeable, and a paresis
of several other muscular powers of the eye is su-
perinduced ; while the retina continues perfectly
sensible to the stimulus of light.
Immutability of sight. Young. Phil. Trans. 1793.
1801. See also Wells. Phil. Trans. 1811, art. xix.

y Senectiitis. From old age, in which the cornea usu-
ally grows less convex ; and hebetude and relaxa-
tion become common to all the powers of the eye.

Presbytia. Linn,

Presbyopia. Auct. Var.

4. PROPiNQUA. Vision only accurate when the object is near*

night-sight^ or that imperfection of vision under which the eye can
only see in the day, or whenever there is a strong Hght. And hence
hemeralopia, the opposite to nyctalopia, has been used with the
same confusion and contradiction of sense ; by the Greeks importing
day-sight, being taken naturally or literally ; by the moderns day-
sight-ache, and consequently night-sight, being taken technically or
by implication ; and hence Sauvages, " Graecis hemeralopia, neoteri-
cis, nyctalopia."

In like manner the amblyopia or dyopia dissitorum of Sauvages
and CuUen, '' morbid sight of distant objects,'''' is the short-sight or
near-sight of colloquial language in all countries ; while their am-
blyopia, or dyopia proximorum, " morbid sight of near objects.," is
the colloquial long-sight of all countries.

In the specific names now offered, the author has avoided the
embarrassment of the first two examples by selecting more appro-
priate terms ; and that of the last two by endeavouring to make the

240 NOSOLOGY. [CL. IV.-OR. II.

Amblyopia dissitorum. Sauv,

■ Djsopia dissitorum. Cull.

Myopia. Linn.

Myopiasis. Vog.

Visus juvenum. Plater.

Kurzsichtigkeit; G.

Vue courte. F.

Short-sight.
5. LATERALIS. Vision only accurate when the object is placed
obliquely.

Amblyopia luscorura. Sauv,
■ ' Dysopia lateralis. Cull.

Luscitas. Boerh.

Schiefen-sehen. G.

Vue couche. F.

Skue-sight. Old Engl. {Sight askew.)

technical and colloquial terms run parallel. Thus paropsis longin-
qua, literally " vision imperfect by being only remote,'''' is the long-
sight of the vulgar. Dr. Cullen, indeed, in his species dysopia
lateralis, " sight imperfect by being only askew or oblique," has
pursued the same mode of interpretation, but then it is a mode of
inrerpretation at variance with all his preceding examples.

1. Paropsis lucifuga. This disease may be the result of at least
two causes : primary irritabihty of the retina ; and deficiency of the
black pigment that covers the choroid tunic. Such deficiency is
occasionally found in persons of a fair complexion and light hair ;
but more frequently in albinos, who in consequence are more sub-
ject to the affection. In old persons the same deficiency is some-
times traced, but without painful vision ; for at this time of life the
optic nerve, like all other nerves, is become more obtuse. In
horses the deficiency constitutes what is called a wall-eye.

This acuteness of vision is natural to cats, lynxes, lions, and per-
haps all the feline genus, which prevent the pain they would other-
wise suffer by a closer contraction of their irids than mankind are
able to effect ; while by a like degree of expansion they are able to
see much better than mankind in the dark.

2. Paropsis noctifuga. The character of this disease is precisely
the reverse of that of the preceding ; and proceeds usually from a
want of sufficient irritability in the retina ; which, in consequence,
is only CKdited to action by a strong stimulus, or powerful light :
and hence does not clearly discern in the shade or towards the close
of day. Hens are well known to labour under this defect; and
hence, they cannot see to pick up small grains in the dusk of the
evening, and so employ this time in going to roost : on which ac-

GE. I.] NOSOLOGY. 24 I

6. iLLUTORiA, Imaginary objects floating before the sight ; or
real objects appearing with imaginary qualities.
Suffusio. Sauv. Sag.
Phantasma. Linn. Vog,
Pseudoblepsis. Cull.
Falsch-sehen. G. •

Berlue. F.
False-sight,

ec, Phantasmatum. Ocular spectres : assuming various
semblances.

count the disease is sometimes called Hen Blindness. See Dune.
Med. Com. xix. 294.

3. Paropsis longinqua. In the preceding species the hebetude
seems chiefly to appertain to the retina : in the present species it
belongs chiefly to the iris, which is habitually dilated and not easily
stimulated to a contractile action. For " it is well known," ob-
serves Dr. Wells, " to those who are conversant with the facts
relating to human vision, that the eye in its relaxed state is fitted
for distant objects, and that the seeing of near objects accurately. is
dependant upon muscular exertion." Phil. Trans. 18 il, art. xix.
In the paper now referred to, Dr. Wells describes an interesting
case of a person about thirty-five years of age, whose retina Wa^Taa
sensible to the stimulus of light as ever; yet who from a paresis,'or
permanent dilatation of the pupil, saw near objects with considera-
ble confusion ; but remote objects with perfect accuracy. The
power of moving the upper eye-lid was also lost. It was an ex-
treme case of the disease before us, complicated with partial para-
lysis of the adjoining muscles, and may be imitated by applying the
tincture of belladonna. It was easily remedied by the use of spec-
tacles with convex glasses, by means of which the patient was able
to read without difficulty in a printed book, whose letters he was
scarcely able to distinguish from each other before the spectacles
were applied. This ought only therefore to be regarded as a
variety of the present species. A third variety is that produced by
old age, constituting the presbytia, and presbyopia of medical
writers (from jrges-Cvs, senex,) in which case the hebetude and re-
laxation, while short of paralysis, extend usually through the retina,
iris, and indeed every part of the compUcated organ of the eye,
for the cornea becomes less convex in its form, and less pellucid in
its transparency. >

4. Paropsis propinqua. See the preceding note. Mice are sup-
posed to have this kind of vision naturally ; and hence the name
that has been given to it of myopia, or mouse-sight.

5. Paropsis lateralis. In this species the patient can see only ob-
liquely, in consequence of some partial obfuscation of the cornea,

31

242 NOSOLOGY. [CL. IV.-OR. II.

1 . Dark spots. Muscas volitantes. Auct, Var.

Myodesopsia. Plenck.
Suffusio myodes. Sauv»

2. Net-work. Visus reticularis. Plenck.

Suffusio reticularis. Sauv.
This is Sometimes permanent ; sometimes fuga-
cious ; and is probably, as conjectured by Sauvages,
produced by a morbid affection of the arteriolae of
the retina.

3. Sparks. Suffusio scintillans. Sauv.

Generally from a blow or excess of light.

4. Dazzling. Marmaryge. Hippocr. Vog.
' Photopsia. Plenck.

Usually from plethora of the vessels."^

5. Iridescence. Suffusio coloris. Sauv.

From the preceding cause.
C Mutationis. Real objects changed in their natural
qualities.
Metamorphopsia. Plenck.

1. Error of form. Suffusio metamorphosis. Sauv^

In this respect they are too large, too small, cut
in half, distorted.

2. Error of motion. Suffusio nutans. Sauv.

This consists usually in dancing, nodding, or
rapid succession.

(usually perhaps from scratches or slight scars,) or of the humours
through which the light is transmitted ; or from a partial paralysig
of the retina. This must not be confounded with strabismus, or
squinting, which proceeds from a different cause ; and is accompani-
ed with different phenomena. In lateral vision, the axis of the eye
affected usually coincides with that of the sound eye, though it runs
somewhat obliquely to avoid the obstruction in the tunic. In
strabismus the two axes do not coincide, and the judgment is formed
from the strongest eye alone. If, however, in lateral vision, the
obstruction be such as to make the optical axis of the affected eye
at variance with that of the sound eye, squinting must be a neces-
sary consequence of the disease.

G. tc. I. P. illiisoria, Phantasmatum : Dark spots. "These ap-
pearances are sometimes, if not always, occasioned by an opacity
of some of the vessels of the vitreous humour, near the retina.
They are seen in a full light, and cannot, therefore, as Sauvages
has justly remarked, be caused by any thing in the anterior part of
the eye ; and they may often be observed to change their form with
the motions of tlje eye ; which they could not do if they did not

OE. I.] NOSOLOGY. 243

3. Error of number. Diplopia. Sauv. Plenck.

Often doubled, tripled, or otherwise increased,
or multiplied.

The chief causes are those enumerated under •.
Many of these ocular illusions are found also, as
symptoms, in several species of dinus, syspasia,
syncope, plethora cephalitis, and various fevers.
7. Calico. Dimness or abolition of sight from opacity of the
cornea, or spots upon its surface.
Caligo corneae. Cull.

Obscuratio cornea. — Maculae corneae. Plenck,
Phtharma caligo. Young.
Caligo a nephelio. C. a leucomate. Sauv.
Oma. Arab.

Verdunklung der hornhaut. G.
Nouage de la cornee. Taye. F.
Opake Cornea.
Web-eye.

Hence, Shakspeare, "This is the foul fiend. Flib-
bertigibbet : he gives the web, and the pin, squints the
eye, and makes the hare-lip."
6. Glaucosis. Dimness or abolition of sight, from opacity of
the humours.
Glaucoma. Fog.
Phtharma Glaucoma. Young.
Caligo a rhytidosi. Sauv. Mouchart.

depend on some floating substance. Their apparent change of
position, when we attempt to follow them with the eye, is a neces-
sary consequence of the motion of the eye itself which contains
them." Ytung.

7. Paropsis Caligo. Caligo, Lat. " dimness, darkness, obscurity,
cloudiness." The immediate cause is often unknown. Baran Storck
strongly recommended an extract of the pasque-flower, Pulsatilla
nigricans, the anemone Pulsatilla, Linn, for internal use ; and from
the success he ascribes to it, the plant has found its way into the
Edinburgh pharmacopoeia. The anemone pratensis would probably
answer as well.

8. Paropsis Glaucosis. TXccvuuati^ from yXccvxai, " blueish or
greenish tinted," from the general colour of the obscurity. It was
also called by the Greeks glaucoma, and by the Romans glaucedo.
Glaucosis is here preferred to glaucoma, because the final oma
usually, and for the sake of simplicity and consistency, ought always
to import external protuberance, as in staphyloma, sarcoma, &c.
See the Preliminary Dissertation.

244 rv'osoLOGT. [cl. iv.-or. ii^

Caligo. a defectu humoris aquei. Sennert,
Verdunklurig der glasernen feuchtigkeit. G.
9. Cataracta. Dimness or abolition of sight from opacity of
the crystalline lens.
Hypochyma {vv»jivnet.) Auct. Grcec.
Cataracta. Sauv. Linn, Fog. Sag. Plenck.
Phtharma Cataracta, Young.
Caligo lentis. Cull.
Kafes. Pers. Turc.
Graue-staar. G.
Cataracte. F.
Cataract,
tc. Lenticularis. Lenticular. The opacity existing in the

lens itself and-^confined to it.
C Capsularis. Capsular, or membranous. The opacity

confined to the capsule, or membrane of the lens.
y Complicata. Complicated. The opacity common to
the lens and its capsule.

See Richter Von der Ausiehung des grauen Staars ;
and Hellman Von grauen Staar, und dessen heraus-
nehmung.
JO. Synizesis. Dimness or abolition of sight from contraction
or obliteration of the pupil.
Synizesis. Vog. Plenck,
Caligo a synesesi. Sauv.
Caligo pupillae. Cull.
Augensternverengerung. G.
tt Simplex. Simple closure of the pupil.

The pupil becomes closed or obliterated from pro-
gressive contraction, and at length coalition, of the
muscular fibres of the iris ; from inflammation of the
surrounding membranes ; or from protrusion of the
iris. In all these cases it is called simple obliteration of
the pupil.

9. Paropsis Cataracta. From x«T«g«<yy«, " to disturb, destroy,
abolish." The Greeks called this disease indifferently hypochyma,
{y'Jt»xfli**')) apochysis {^k-7tt>y,v(rii.,) and hypochysis ((J7r«;cwr<j.) The
earlier Latins suffusio. See Gunzii De Suffusionis natnra et sede.
Richter Chir. Bibliothek. St. Yves., nouveau Traite des maladies des
yeux 1136. — Cataracta was, perhaps, first employed by the Arabian
writers.

10. Paropsis Synezesis. From o-dk^*, " consido, coeo, coalesco ;"
from the coalition of the muscular fibres of the iris. See Transact,
of the Swedish Academy^ vol. xxxiv ; and fVeissenborn De Pupilla ni-
rais coaretata. Erfurt, 1773.

GE. I.] NOSOLOGY- 245

S Complicata. Closure of the pupil, complicated with
cataract, or an opaque cornea.
Plenck confines synezesis to a total contraction of the
pupil, making a distinct disease of its partial contraction,
which he calls myosis ; and another distinct disease of
the variety C, which he calls synechia. But this is to
perplex rather than to simplify the subject.
11. Amaurosis. Dimness or abolition of sight, with an unaltera-
ble pupil, usually black and dilated •, but
without any other apparent defect,
Immobilitas pupillae. Plenck.
Amaurosis. Sauv. Linn. Vog, Sag.
Gutta-serena. Arab.
Schwarze-staar. G.
Goutte- serene. F,

Drop serene. — So Milton, in his address to Light, in
which he also alludes to the cataract by the Latins
called suffiisio :

'^ Thee I revisit safe,
And feel thy sovereign vital lamp ; but thou
Revisii'st not these eyes, that roll in vain
To find thy piercing ray, and find no dawn ;
So thick a drop serene has quench'd their orbs,
Or dim StrFFUSiON veil'd."

The most common cause is a paralysis of the retina,
usually in conjunction with a paralysis and dilatation of
the iris. Occasionally, however, the iris is rigidly con-
tracted, its debility being accompanied with great irrita-
bility : and hence offering two varieties ; to which a
third may be added, from the disease assuming at times
an intermitting type.
K Atonica. With permanent atony and dilatation of the

pupil.

C Spasmodica. With permanent contraction.

y Intermittens. With periodical cessations and returns.

Plenck makes a distinct disease of an unalterable

pupil roilh or without injury of vision, under the name

of Mydriasis. In the latter case it is evidently a va-

11. Paropsis Amaurosis. From xf^eiv^tg, " obscurus, caliginosus,
opacus." " Rarissime nascitur hie morbus sine omni praedisposi-
tione." Plenck. in loc. — Warner strongly recommended Dippell's
Animal Oil, both externally and internally. On the Human Eye, p. 22.

12. Paropsis Staphyloma. From <rT«(pvA»5, " uva," a grape, from

246 NOSOLOGY. [CL. IV.-OR. 11.

riety of amaurosis ; and it is questionable wliether
the Ibrmei- case ever exists.

Found also, occasionally, as a symptom or sequel in
hysteria, syspasia, and lues.

It is probably to the second of these varieties that
Shakspeare often alludes by the term pin or pin-eye,
the pupil being contracted to nearly the diameter of
a pin's head. The following example is sufficient,
another having been already quoted under P. Ca%o;

*' Wish all eyes
Blind with the pin and web."

12, STAPHyL6MA. Enlargement of the ball of the eye ; protu-
berance of the cornea ; sight dim or abo-
** '■ lished.

Staphyloma. Sauv. Vog. Sag, Phnck.
, Staphylom. G.
Clou. F.
Protuberant eye.

m Simplex. From increased secretion of the aqueous or
other humour : pupil transparent.
Hydrophthalmia. Vog. Plenck.
i Purulentum. From flovsr of pus from an abscess in

one of the membranes ; pupil cloudy.
'Onyx. Plenck. When between the lamellae of the

cornea.
Hornhautapostem. G.

Hypopyum. Plenck. When in the aqueous humour.
Eiteraug. G.
y Complicatum. Complicated with a rupture of the
iris, and its protrusion upon the cornea ; constituting
a grape-like tumour: sight abolished.
Straphyloma complicatum. Plenck.

The genera of Plenck, exophthalmia, opthalmopto-

sis, and ptosisiridis, are resolvable into the present ;

they proceed from similar causes, exhibit the same

appearance, and, when manageable, are to be treated

.. by the same means : one of the most useful of which,

'in diminishing the protuberance, is that of illining the

the resemblance of the tumour to the pulpy and semi-transparent
appearance of this fruit. Richter has the credit of having first
pointed out the real nature of this disease. Fascic. II. Observ.
Chirurg. p. 104.

GE. I.] NOSOLOGY. 247

opake cornea with a minute drop of butter of antimo=
ny on the lip of a small pencil-brush, as first recom-
mended by Janin, and afterwards by Richter. ■ :.
13. Strabismus. Optic axes of the eyes not coinciding 6n an
object.
Strabismus. Sauv, Linn, Plenck. et alior.
Ahul. Arab,
Schielen. G,
Louchette. F,
Squinting.

Goggle-eye, Old. Engl. — This, word is still retained in
the term goggles, or glasses for persons affected with
the disease : by the French called masques a couchette.
«• Habitualis. From habit : or the custom of using bne
eye and neglecting the other; whereby the latter
grows gradually more unsteady, and the will has no
longer an equal command over both.
Nystagmus. Plenck.
Strabismus habitualis. Cull.
Strabismus vulgaris. Sauv.

13. Paropsis Strabismus. ^T^uQtiTfc*g, from 9-t§«C«5, " tortus oculis."
The optic axis is an imaginary right line passing from the center of
the vitreous humour, lens, and globe of the eye, to the object of
vision. In perfect vision the optic axis of the one eye is in unison
with that of the other, and consequently they converge or coincide
at the same point; and the object which would otherwise appear
double, as being seen by each eye, is contemplated as single. In order
to this coincidence, Ihe muscles of each eye must constantly assume
the same direction, their position and configuration be precisely
alike, and the sight be of an equal power and focus : a deviation
from each of which postulates must necessarily produce squinting,
or an inaccordant action of one eye with the other. From common
and early habit we acquire an equal command over the muscles of
both, and are able to give them any direction, and to fix them
against any object we please : and such is the power of habit, that
at length they involuntarily associate in the same action, and it is
difficult for us to give to the one eye a different direction from that
of the other, or in other words, to make their optic axes diverge
instead of converge. In persons born blind, no benefit can be de-
rived from this unity of action, and hence it is never attempted;
and the muscles being never subjected to discipline, the eye-balls
roll at random, and wander in every direction. And hence one of
the most difficult tasks to be acquired by such persons after obtain-
ing sight, is that of keeping their eyes fixed, and giving the same
bearing or convergent line to each. And hence, again, they see
things double at first, and in a state of great confusion.

"*'i^ NOSOLOGY. [CL. IV.-OR. II.

C Atonicus. From debility of the effected eye : whence
the sound eye possesses a different focus and power
of vision, and is alone trusted to : in consequence
of which the weak or neglected eye insensibly
wanders as above.

Strabismus commodus. CulL

Strabismus Buffonii. — S. spasmodicus. — S. paralyt.
Sauv.
y Organicus. Differently constructed in form or posi-
tion : so that the situation or figure of one eye, or
of particular parts of one eye, are inaccordant with
those of the other: whence, as in the preceding
varieties, one eye is chiefly depended upon, and
the other neglected.

When one eye is naturally stronger, or of a more favourable fo-
cus, or more frequently employed than the other, as among watch-
makers and jewellers, the latter from comparative neglect relapses
into an undisciplined state, and less readily obeys the control of the
will. Its muscles do not assume the same direction, and if they do,
in the two former cases, the object appears double ; and hence the
neglected or weaker eye wanders and stares at one or at various ob-
jects, while the eye relied upon is fixed upon some other. And it
is this divergence of the optic axes, this inaccordance of direction,
or looking at different objects at the same time, that constitutes the
disease called strabismus or squinting,

14. Paropsis Ectropium. 'Exr^oTrtov : from atrgijrw, " averto, deflecto,
detorqueo." The opposite affection or inversion of one or both
eye-lids, is denominated entropium. It is often a very troublesome
complaint from the irritation produced by the inverted eye-lashes.
But it is, perhaps, in every instance a symptom or sequel of some other
disorder, as a tumour seated on the affected lid, or a contraction of its
internal membrane from a cicatrix, or other cause. See Platntr
De Vulneribus superciUis illatis. Opusc. tom. ii. Jicrel Bemurkun-
gen, &LC.

Gen. II. Paracusis. n«g<«xvcr<;, Tragawtoij, from 7rti^etx»va, " perpe-
ram, depravate, vitiose audio." The mechanism of the ear is as
complicated as that of the eye, and as admirably adapted in all its
parts to the perfection of the sense which constitutes its function.
Its lobe, its entrances, its openings, its various drums, its minute and
multiplied foramina, its delicate bones, all contribute to one common
effect. Even the surrounding bones, and still more than this, the
teeth are, in no small degree, auxiliary to the same object ; as the
experiments of M. Perolle, given in the fifth volume of the Turin
Transactions, have abundantly established ; as they have also that
bone in general is a far better conductor of sound than air, alcohol,
or water.

GE. 11.] NOSOLOGY. 249

14. EcTROPiuM. Eversion of one or both the eye-lids ; and
consequent exposure of the red internal
tunic.
Ectropium. Linn. Plenck. Fog. Ware. Adams.
Blepharoptosis Ectropium. Sauv.
A .; -artskenrung des augen-lieds. Plenck.
Eraii 'cement, t".
Eversion of the eye-lids.

Found also, as a sequel, in inflammation of the con-
junctiva, purulent or chronic ophthalmy, smail-pox,
burns, and scalds.

GENUS II.

PARACUSIS.

Sense of hearinor vitiated, or lost.
Paracoe (Trajaxsji.) Hippocr.
Cophosis. Linn.
Dysaesthesia auditoria. Youngs
1. Acms. Hearing painfully acute, and intolerant of the lowe^i
sounds.

From the complicated organism of the ear it follows necessarily,
that, like the eye, it must be subject to a great variety of diseases ;
while many of the diseases of the one sense must bear a striking
analogy to those of the other. Thus painful and obtuse hearing,
and deafness, may be well compared with painful and obtuse vision,
and blindness. As the eye is at times affected with illusory objects,
so is the ear with illusory sounds; and, as, when the optic axes do
not harmonize, as in strabismus, the same object may be seen double,
so may the same sound be heard double where the action of the
one ear is inaccordant with that of the other. Sauvages has given
two or three very curious examples upon this last affection : A
musician, while blowing his flute, heard two distinct sounds at every
note. The sounds were in different keys, and consequently not in
harmony : and as they were heard simultaneously, the one could
not be an echo of the other. This singular affection seems to have
heen the result of a catarrh, and ceased on its termination. On
another occasion he was consulted by a person who for several
months antecedently had been troubled with a hearing of two dis-
tinct voices whenever he was spoken to : the one at least an octave
32

250 NOSOLOGY. [CL. IV.-OR. 11.

Auditus acrior. Darw.
Paracusis Oxycoia. Sauv.
Ouie lendre. F.

Sometimes found idiopathically in nervous and highly
irritable idiosj^ncrasies, and bearing a striking analogy
to paropsis acris.

Found, more frequently, as a symptom in ear-ache,
head-ache, epilepsy, otitis, cephalitis, and fevers of va-
rious kinds.
"i. OBTUSA. Hearing dull and confused; and demanding a
clear and modulated articulation.
Disecoia. Auct. GrcBC, Vogel,
Dysecosa. Saitv. Sag. CulL
Auditus difFicilis. Hoffm.

higher than the other, but not'in unison with it, and hence produc-
ing a harsh and insupportable discordancy. Tom. I. 766.

The perverse paracusis, forming the third species of the present
arrangement, though perhaps more common, is not less extraordi-
nary ; and the same attentive and indefatigable writer has collected
various examples of tiiis disease from unquestionable authorities.
The first case is that of a woman v/ho could never understand what
was spoken to her unless a drum were beating close to her at the
same time ; and who, on this account, kept a drum always in the
house, which was constantly played upon while she was conversing
with her husband. Another case is that of a bell-ringer, who could
never distinguish speech except while the bells were ringing. A
third case relates to a person who was always deaf except when
travelling in a carriage, during which time, from the rattling of the
wheels, he was perfectly capable of hearing, and in engaging in
conversation. Sauvages ingeniously ascribes this disease to torpi-
tude or paresis of the organs of the external ear, which require
this additional stimulus to rouse them into action, so as to convey
the proper sounds addressed to them, be3'ond the tympanum.
And he closes with the following illustrations : " Sic somnolenti
oculos non aperiunt, nee proinde aptant ad visum, nisi magna lux
oculos commoveat ; sic organa genitalia ganeonum a torpore exci-
tantur quandoqne per Hagra, de quorum usu in rea venerea scripsit
Meibomius." Tom. I. 767.

As the organ of the ear, however, is less exposed than that of
the eye, we are far less acquamted with the immediate seat of its
diseases ; and even with the exact bearing which every particular
part sustains in the general phenomenon ol" hearing. It was at one
time supposed that Ihe nicest power of discriminating sounds,
or in other words, that accuracy of distinguishing which constitutes
what is called a musical ear, is seated in the cochlea. Ijirds, howe-
ver, whose perception is exquisite, have no cochlea. It has since

GE. II.]

NOSOLOGY. 251'

Auditus imtninutus. Darro.

Vekr. Jlrab.

Ubel-hbren. G.

Durei6 d'oreille. F.

Flarchiess of hearing.

« Organica. From organic defect.

Djsecoea organica. Cull.
C Atonica. From local debility.

Dyseccea atonica. Cull.

Kervous deafness.
y A meatu obstructo. From obstruction in the auditory
lube or passage : as by mucus, wax, sordes, an in-'
sect, or any other extrinsic body.

been conceived by Sir Everard Home that it is the membrana tym-
pani in which this fine feehng is peculiarly lodged {^Phil. Trans.
1800,) and that it depends upon its muscularity : yet the same feel-
ing has remained, and in its full proportion, in persons whose mem-
brana tympani has been ruptured.

In Sauvages, hardness of hearing, perverse or depraved hearing,
and deafness, are made distinct genera under the names of dyseccea,
paracusis, and cophosis. Cullen throws away the last of these, as
a distinct genus, and arranges the affections that belong to it under
dysecoea ; regarding hardness of hearing and deafness as only dif-
ferent degrees of one conomon malady. Neither of these views are
correct. First, there ought to be but one common genus for the
whole, and to this the writer of these p-iges has given the name of
paracusis, as well out of deference to the authority of Hippocrates,
who has employed it in the same extensive sense, as on account of
its analogy with paropsis, the preceding genus. In the next place,
deafness and hardness of hearing are by no means the same com-
plaint; the latter may, indeed, occasionally terminate in the former;
but it may also, and often does continue to the close of life, some-
times even from the beginning to the close, without ever running
into deafness ; and probably its seat lies generally in other parts of
the auditory organ than that in which deafness is situated. Dys, in
dyseccea, is by Cullen used as a diminutive or negative, " auditus
imminutus vel abolitus,'' says he, in his definition of the term ; per-
versity or depravity being expressed by para, as in paracusis, which
he explains '• auditus depravatus." Yet by dys, in his dysopia, he
intends neither a negative nor a diminutive, but a perverse or de-
praved power ; his definition of the term being " visus depravatus ;"
in which case dys is confounded with para in his own previous inter-
pretation of this preposition. Such looseness of meaning should be
avoided as much as possible in works of science, and especially ia
works for the n?e of students.

252 NOSOLOGY. [CL. IV.-OR^ II,

Dysecoea a meatu obstructo. Sauv,
Djsecoea a tuha obstrucia. Id.

Found also, occasionally, as a symptom or sequel,
in various fevers, hemiplegia, apoplexy, otitis, lues,
and polypous caruncles or concretions in the pas-
sage of the ear.
3. PERVERSA. The ear only sensible to articulate sounds when
excited by other and louder sounds intermix-
ed with them.
Paracusis Willisiana. Sauv.
Paracusis imperfecta (d.) CuU»
Ouie engourdie. F,
Perverse hearing.

Only when several bells were ringing at the same
time. Birch Hist. Vol. IV. — Only in a great noise.
Fieliz ; RicLfer. Chirurg. Bibl. Band IX. p. 555.—
Only during the music of a pipe. Stahl Colleg. p. 76.
— Easier in a great noise. Sims. Memoirs Med. Soc.
Lo'id. Vol. I. n. 5.
4* DUPLicATA. The action of the one ear inaccordant with that
of the other : sounds heard doubly and in
different tones or keys.
Paracusis duplicata. Sauv.
Paracusis imperfecta (c.) Cull.
Unrecht horen. G.
Double ouie. F.
Double-hearing.
S, iLLUSORiA. Internal sense of sounds, without external causes.
Paracusis imaginaria. Cull,
Syrigmus. Sauv.
Susurrus. Fbjsf.
Nemim. Jlrab.
Imaginary sounds.

ft Syrigmus. Ringing or tinkling ; a sharp, shrill, suc-
cessive sound.
C Susurrus. Whizzing. An acute, continuous, hissing

sound.
y Bombus. Beating. A dull, heavy, intermitting sound.
There are numerous other varieties, but it is need-
less to detail them.

■ Gev. hi. Parosmis from waga, " male," and o^«, " oleo," " olfa-
<JiiO;" analogously with paracusis and paropsis, and h°nce preferred
to parosmia. The common term among nosologists is anosmia, but

GE. in.] NOSOLOGY. 253

6. SuRDiTAS. Total inability of hoaring or distinguishing
sounds.

Cophosis. Soiiv. Sag.

Surditas. Vog.

Dysecoea organica. Cull.

Samem. Arab.

Taubheit. G.

Sourdite. F.

Deafness.

» Org^inica. From organic defect,

g Atonica. From local debility.

y Paralytica. From local palsy.

Found also as a symptom, occasionally as a sequ^,
in various fevers, hemiplegia, apoplexy, otitis, and
lues; and, when congenital, or occurring shortly after
birth, the cause of aphonia surdorum, or deaf-dumb-
ness.

GENUS III.

PAROSMIS.

Sense of smell vitiated, or lost.

Anosmia. Sauv. Linn. Vog. Cull.
Olfactus amissio. Sennert.

this only includes one species of the genus, namely, privation or
destitution of smell ; which, in fact, is the only one that has hitherto
been introduced into nosological systems. Darwin, indeed, has
olfactus acrior, but without any definite meaning or example : — a
nominis umbra^ to be embodied by subsequent writers.

1. Parosmis acris. Generally speaking, the sense of smell in all
animals is in proportion to the extent of the Schneiderian or olfacto-
ry membrane with which the nosti ils are lined, and over which the
branches of the olfactory nerves divaricate and ramify. And hence
this membrane is much more extensive in quadrupeds and birds,
which chiefly trust to the sense of smell in selecting their food,
than in man ; for it ascends considerably higher, and is for the most
part possessed of numerous folds or duplications. It is hereby the
hound distinguishes the peculiar scent thrown forth from the body
of the hare, and the domestic dog recognizes and identifies his
master from all other individuals.

254 NOSOLOGY. [CL. IV.-OR. l^

Dysassthesia olfactoria. Young,
Odoratus depcrditus. Phuquet,

1. AGRis. Smell painfully acute, or sensible to odours not ge-

nerally perceived.
Olfactus acrior. Darw.
Acute smell,

2. OBTUSA. Smell dull and imperfectly discriminative.

Obtuse smell.
■ 3. EXPERS. Total inability of smelling or distinguishing odours.
Perte d'odorat. F.
Loss of smell.

M Organica. From organic defect, or accidental de-
struction of the olfactory nerve, or its brancht's ; or
of the Schneiderian membrane over which they are
spread.
_ ^y Anosmia organica. Cull.

Under peculiar circumstances, however, the ordiniirj apparatus
ibr smell possesses an activity, and sometimes even an intoierable
keenness, which bj no means belongs to it in its natural state. M.
Virey, who has written a very learned treatise upon the subject of
odours, asserts that the olfactory sense exists among savages in a
far higher degree of activity than among civilized nations, whose
power of smell is blunted by an habitual exposure to strong odours,
or an intricate combination of odours, and by the use of high fla-
voured foods. And he might have added, that this sense like every
other, is capable of cultivation, and acquiring delicacy of discrimi-
nation by use ; that savages, many of whom make a near approach
to the life of quadrupeds, employ it, and trust to it in a similar
manner; and that this is, perhaps, a chief cause of the difference
he has pointed out. It is in like manner relied upon by persons
who are deprived of one or two of the other external senses, as
those of sight or hearing, or both ; and in these cases it often ac-
quires an extraordinary degree of nicety. In the interesting ex-
ample of the boy born blind and deaf, lately given to the world by
Professor Stewart, and who, in consequence, v/as obliged to rely
upon the two faculties of smell and touch alone, in discriminating
almost all the objects that surrounded him, he is said, in Mr. Ward-
rop's history of the case, to have employed the sense of smell on
all occasions, like a domestic dog, in distinguishing persons, and
chiefly to have depended on it. l>y this sense he identified his
friends and relatives ; and conceived a sudden attachment or dislike
to strangers according to the odour of the efiluvium that escaped
from (ho skin.

The Journal dcs Scavans^ an. 16G7, gives a curious history of a
monk, who pretended to be able to ascertain, by the dilFerence o(

QE, IV.] NOSOLOGY. • 2^^

C Paralytica. From local palsy.
Anosmia paralytica. Sauv.
Anosmia atonica. Cull.

Found also, occasionally, as a symptom in catarrh,
worms, lues, local ulceration, and fevers of various
kinds.

GENUS IV.
PARAGEUSIS.

Sense of taste vitiated or lost.
Apogeusis. Vog.

Ageustia. Sauv. Sag. Cull. '->'

Dysesthesia gustatoria. Young.
1. ACRis. Taste painfully acute, or sensible to savours not
nerally perceived.
Gustus acrior. Darw,
Acute taste.

odour alone, the sex and age of a person, whether he were married
or single, and the manner of Ufe to which he was accustomed.

This, as far as the fact extended, may possiblj' have been the
result of obseruations grafted upon a stronger natural sense than
belongs to mankind in general ; and is scarcely to be ranked in the
list of diseased actions. But among persons of a highly nervous or
irritable idiosyncras}', the present writer has met with numerous
instances, and doubtless other practitioners have also, of an acute-
ness of smell almost intolerable and distracting to those who were
labouring under it : which has fairly constituted an idiopathic affec-
tion : and sometimes nearly realized the fanciful description of the
poet by making its possessors read}', at every moment, to
Die of a rose in aromatic pain.

There is a curious and ingenious paper in the Transactions of
the Swedish Academy, Tom. I. p. 346, from the pen of Linneus.
entitled " Fetiveria, en Americansk va.xt,'"' (the American Petiveria
alliacea ;) containing a variety of useful observations on the peculiar
qualities given to the smell, taste, and other properties of animals,
in consequence of their feeding on different foods. The reader
may consult it at his leisure.

Gex. IV. From ysu«, '•'• gmtum prabcu^"' whence »r«g«yft;w, and
consequently ;rag«yjv(r/f. The author has preferred, with Vogel,
the present termination to parageusia or ageusia, as analogous to

256 NOSOLOGY. [cL. IV.-OR. II.

2. OBTUSA. Taste dull and imperfectly discriminative.

Obtuse taste,

3. EXPERS. Total inability of tasting or distinguishing savours.

Degout. F.

It Organica. The papillae of the tongue destitute of
gustatory nerves, or covered with a mucous, or
other sheath which they cannot penetrate.
Ageustia organica. Cull.
C Paralytica. From local palsy.
Ageustia paralytica. Sauv,
Ageustia atonica. Cull.

Found also, occasionally, as a symptom or sequel
in fevers, apoplexy, different species of ecphronia,
and other phrenic genera, and dyspepsy.

GENUS V.

PARAPSIS.

Sense of touch or general feeling vitiated or lost.
. Dysaesthesia contractoria. Youngs

the names of the preceding genera of the order before us And
for the same reason he has preferred para^ to dys : the privative «;
would be altogether inadmissible, as it can only apply to the second
and third species.

The first and last species are perhaps chiefly symptomatic, though
not always so. The second is common, and is often connected with
obtuse smell; for physiologists have remarked a striking coinci-
dence and sympathy between these two senses; and some have
conceived them to be mere modifications of each other. The
writer of these pages had I'ately a lady of twenty-four years of age
under his care, of great mental taste and accomplishments, who had
always possessed a considerable hebetude of both senses. She
could distinguish the smell of a rose from that of garlic, and the
taste of port-wine from mountain or madeira ; but she could not
discriminate between the odour of a rose and that of a lily ; or
between the taste of beef, veal, or pork ; and consequently, upon
all these points, had no preference of relish.

Gen. V. I'arai'Sis. nagarl'*?, irom «7rT»iM«<, «-4''5, " tango, taclus;"
whence vcc^xTrTCfiui and ^raga^'/j, " perperam tango, intactus."

'J'lie conuiioti term among tlic no&ologists in r/»/sa;A</(es?'a ; but in-
correctly, since this word, as already observed, is also employed to

iJE. V.j NOSOLOGY. :2.i7

1. ACRis. Touch painfully acute, or sensible to impressions
not generally perceived.
Tactus acrior. Darw.

M, Teneritudo. Painful uneasiness or tenderness, local
or general, on being touched with a pressure usu-
ally unaccompanied with troublesome feeling.
Soreness.

Occasionally unconnected and idiopathic, but more
frequently a symptom or sequel of fevers, debility,
lassitude, violent exercise, catching cold.
Z Pruritus. Painful titillation, local or general, relieved
by rubbing.
Pruritus. Sauv. Linn. Vos. Sas. Darw.

O

Autalgia pruriginosa. Young.
Itching.

As an idiopathic aflcction chietiy local, and easily
relieved by rubl^ing or scratching.

Found also, as a symptom, in prurigo and other
papulous affections, purnio and other cutaneous in-
flammations ; urticaria, and other cutaneous erup-
tions.

express morbid sensation of any kind, whether of touch, taste,
smell, sight, or hearing. See the note on ^Esthetica at the begin-
ning of the present order. But by Dr. CuUen the radical term is
used with a pecuhar want of precision : for while dysassthesiaB with
him constitutes the name of the present order, and embraces the
external senses at large, anaesthesia is at the same time limited to
that of touch. In this perplexity of significations he appears to be
alone ; for though Sauvages uses dysaesthesiae as an order, and
anaesthesia as a genus, he uses both in the same general meaning ;
and hence the anesthesia of Sauvages is a different disease from
that of Cullen, and imports privation of all the senses, while muscu-
lar motion, and a desire for things needful remain, though with
diminished power. His words are " sensfis omnis privatio, su-
perstitibus motu musculari, et rerum necessariarum appetitij, sed
imminutis." It constitutes the parapsis expers, var. b, of the pre-
sent system ; and his species and examples are illustrative of it.
Sagar follows the use of the term adopted by Sauvages. Linneus
and Crichton employ anaesthesia in the import of Cullen, and limit
it to privation of touch ; but then they do not employ dysassthesise
at all, the former substituting the term privation in its stead, and
the latter distributing the diseases hereby usually embraced, under
other divisions of his arrangement.

Dr. Young employs dysaesthesiae upon a wider scale than any of
the preceding writers; for he not onlv allows it to reach all the
3.3

258 NOSOLOGY. [CL. IV.-OR. II.

y A Igor. Sense of temperature, local or general, below

that of pleasant and natural warmth.
Algor. Sauv. Sag.
Zemherir. Arab.
Coldness,

As an idiopathic atiiection chiefly local, and most
common to the head and feet.

Found also, as a symptom, in the first stage of fe-
ver, sjmcope, hysteric syspacia, nausea, and atonic
empathema ; in all which the affection is general.
5 Ardor. Sense of temperature, local or general, above

that of pleasant and natural coolness.
Ardor. Sauv. Sag.
Hararet. Arab.
Heat.

As an idiopathic affection occurring chiefly in ple-
thoric and irritable habits.

external senses, but carries it into the mind, and makes it embrace
•■' want of memory, or confusion of intellect," which he denominates
dysKsthesia interna : though he introduces the affection with a
query.

1. y P. acris, Algor. "Cold, according to its degrees, produces
two very different effects ; one is the exciting of action without
lessening the powers, the other is absolutely debilitating, while at
the same time it excites action if carried too far." Hunter on
Blood, p. 349. It is observed by Dr. Fordyce, in his Tract on
Simple Fever, p. 168, and the observation is quoted and called
curious by Dr. Darwin, ••' that those people who have been confin-
ed some time in a very warm atmosphere, as of 120 or 130 degrees
of heat, do not feel cold, nor are subject to paleness of their skins,
on coming into a temperature of 30 or 40 degrees ; which would
produce great paleness and painful sensation of coldness in those
who had been for some time confined in an atmosphere of only 86
or 90 degrees." The cause is not difficult of explanation. The
sensorial power is exhausted by a long application to a heat of 120
or 130 degrees, and the minute vessels lose their power of spas-
modic constriction, or collapse : while in a heat of 86 or 90 degrees
no such effect takes place.

1. Parapsis expers. Some persons have an habitual numbness or
privation of the sense of feeling in particular parts of the surface,
which appears to depend on local deficiency or paralysis of the
nerves of touch. And hence they are able, in such parts of the
body, to prick or cut themselves, or to run pins to any depth below
the skin without pain. The author has seen several striking ex-
amples of this peculiar affection.

/

iSE. v.] NOSOLOGY. '259

Found also as a symptom in the second stage of
fevers, inflammations, and entonic empathema.

2. EXPERS. Total insensibility to objects of touch.

Anaesthesia. Linn. Cull.

K Simplex. Confined locally or generally to the sense
of touch ; sometimes accompanied with uneasiness.

Stupor. Sauv, LAnn. Sag.

Tactus imminutus. Darzo.

J^'$mbness.
C Complicata. Complicated with insensibility in seve-
ral or all the other senses.

Anaesthesia. Sauv. Sag,

See an interesting case in Colled. Acad. torn. III.

p. 184.

Alternating with paralysis. He?5/e?-, Wahrnehmungen
I. p. 205. Medico-chirurg. Trans. Vol. U. p. 216. Case
of Vieusseux, communicated by Dr. Marcet.

Found also, as a symptom, in apoplexy, catalepsy,
epilespy, syspasia, and syncope.

3. ILLUSORTA. Imaginary sense of touch or general feeling in

organs that have no existence.

Sometimes confined to the hands with a full power of motion.
Hist, de VAcad. des Sciences, 1745, p. 40 — Cured by applicanons to
the spine. Galen^ De loc. Off. Lib. I. cap. vi. cl. 7. — Universal, or
extending over the entire surface. Ludovic. Op. p. 938. Ephem.
JVat. Cur. Dec. I. ann. iii. obs. 251. — Confined to the right arm:
the insensibility so great as to be without pain during the progress
of a phlegmon. On breaking the arm the man felt a crash, and
only thought he had broken the spade he was working with.
Lamarck, Philos. Zoologique, Tom. 11. p. 262.

See an interesting paper upon this subject, with several extra-
ordinary cases, and, among others, the above from Lamarck, by
Dr. Yelloly, Medico-chir. Trans. Vol. 111. p. 90. In the case im-
mediately described, the patient, aged 58, had been lirst affected in
Jamaica about three years before, and the affection had become
permanent. " The hands, up to the wrists, and the feet, half way
up the legs, are perfectly insensible to any species of injury, as
cutting, pinching, scratching, or burning. The insensibility, how-
ever, does not suddenly terminate ; but exists, to a certain degree,
nearly up to the elbow, and for some distance above the knee. He
accidentally put one of^ his feet some time ago into boiling water,
tut was no otherwise aware of the high temperature, than by find-
ing the whole surface a complete blister on removing it. l-he ex-
tremities are insensible to electrical sparks taken in every variety
of mode ''

ttJO NOSOLOGY. [CL. IV.-OK. 11.

Pseudaesthesia. Plouquet.

Common to those who have suffered amputation.
See Fogel, Chirurgiscke Wahrnehmungen, Samml. I. n.
9. Act. Med, Berol. Dec. ii. Vol. Vfll.

Found also, occasionally as a symptom, in hypocon-
drias and other mental affections.

ORDER III.

CINETICA.

AFFECTING THE MUSCLES,

Irregular action of the muscles or muscular fibres ; com-
monly denominated spasm.

GENUS I.

ENTASIA.

Irregular muscular action producing contraction, rigidity,
or both.

2. C. P. expcrs complicata. Under this variety Sauvages has given
one or two very curious examples of general insensibility of seve-
ral or all the external senses. The most singular, for which he is in-
debted to the Academy Collections., is that of a delicate young man,
who was suddenly in the morning deprived of speech, and of the sense
of touch, generally without any assignable cause or premonition.
Punctured and pricked in different parts of his body, in his head,
neck, back, shoulders, breast, arms, abdomen, he felt nothing what-
ever, and even laughed ;it the singularity of the phenomenon, as
with the exception of dumbness and cutaneous insensibility he la-
boured under no disease whatever. It continued lor two days, and
appears to have yielded to venesection.

Gen. I. Entasia. 'E»T«a«fi " intentio," " vehcmentia," " rigor."
Soap, in loc. from »m/rw, " intendo." The author has preferred
this word to tonos^ tonus, or entonia, the common terms of nosolo-
giets to express the present genus of diseases, because the latter

[gE. h NOSOLOGY- 261

Tonici. Sauv. Sag.

Convulsionis tonicae. Gorter, EtmulU

Conductiones. Cal. Aur,

Spastici. Linn.

Tonos. Parr.

Entonia. Young,

Tonic Spasm.

1. Priapismus. Permanent rigidity and erection of the penis,

without concupiscence.
Priapismus. Sauv. Linn. Fog. Sag.
Tentigo penis. Plonquet.
Kazech. Mrab.
Priapisme. F.
Priapism.

Has continued after death. Ludovici 0pp. p. 1056.
Marcell. Donat. Lib. II. cap. 3. p. 142. In an infant,
from callosity. Act. Mat. Cur. Vol. II. Obs. 173.

For the most part the consequence of cold, cantha-

rides, clap, or dysury.

2. LoxiA. Permanent contraction of the flexor muscles on the

right or left of the neck, drawing the head ob-
liquely in the same direction.

Loxias (a»|«x5.) Auct. Grose.

Caput obstipum. Vog.

Obstipitas lateralis. Sauv,

Cejahaloxia. Plouquet.

Krumm-hals. G,

Stiff-neck.

K Dispars. From disparity in the length of the muscles
opposed to each other.

C Entonica. From excess of muscular action on the
contracted side.

y Atonica. From direct atony of the antagonist mus-
cles.

terms are employed, in direct opposition to such meaning, by phy-
siologists, to import a healthy and perfect vigour or energy of the
muscles ; and by therapeutists to signify medicines capable of pro-
ducing such or similar effects.

1. Entasia Priapismus. TlfictvtfffAOf. From ng/«w#j, the son of
Venus and Bacchus, who is usually thus represented in paintings and
sculptures. Galen applies the term also to a rigid elongatioa of
the clitoris without concupiscence. - ,

2. Entasia Loxia. From Ae|«s, " obliquus, tortus :'' whence lokar-

262 NOSOLOGY. [CL. 1V.~0R. III.

Obstipitas renuens. Sanv,

Found also, occasionally, as a symptom, in sprains or
inflammations of the neck ; in catarrh ; and in contrac-
tions of the skin of the neck from severe burns.

3. ARTicuLARis. Permanent and rigid contraction of one or

more articular muscles or their tendons.
Acampsia. PlouqueU
Contractura. Sauv, Linn. Sag.
Zemam. Arab.
Yerkiirtzung. G.
, Contracture. F..
Muscular stiff-joint.

» Entonica. From excess of action in the muscles con-
tracted. Articular spasm.
,; C Atonica. From direct atony of the antagonist muscles-

y Inusitata. From long confinement or neglect of use.
! Found also occasionally, as a symptom, in articu-

lar inflammations, abscesses, and ulcers secreting an
irritating fluid.

4, Trismus. Permanent and rigid fixation of the muscles of the

lower jaw.
Trismus. Sauv. Linn. Sag, CulJ.
Capistrum. Fog.
Tonos Trismus. Parr.
Teshennuj. Arab. Pers.
Tic. F.
Locked-jaw.

Parrots are said to be subject to this disorder. Bajon.
Memoires I. Richter, Chir Bibl. band V. p. 165.

Most effectually cured by large doses of laudanum
and drastic purges. A dram of tincture of opium has
been given every hour or every tw^o hours for two days,
with strong doses of calomel, jalap, and scammony, and
proved successful. See two cases by Mr. Harkness,
and Mr. Parkinson, jun. in Trans, of the Medico-chir.
Soc.U. 284. 291.

thrus in surgery, an obliquity of a joint of any kind without spasm
or luxation. By the Greeks, however, the term was specially ap-
plied to the joint or muscles of the neck.

4. Entasia Trismus. Tg ffftoi- From t^i^o). strith, " to gnash."
The Greek term, like its Krench synonym ac, is said by the lexico-
graphers to be an onomatopy, or a word formed from the sound thai
takes place in the act of gnashing.

GE. l] nosology. 203

« Nascentium. Attacking infants during the first fort-
night after birth. Probably the result of acrimony
in the stomach.
•*: Trismus nascentium. Sauv. Cull.

C Traumaticus. Occurring at every age as the conse-
quence of a wound, puncture, or ulcer ; chiefly in
hot climates.
Trismus traumaticus. Hiesier, Sauv, Cull,
Spasmus maxillas a vulnere. Compend, Med.
y Algidus. Occurring after exposure to cold and damp,
especially the dew of evening.
Trismus catarrhalis. Sauv.

There is little difference in the symptoms of any of
these varieties ; and they are here chiefly entered on
the authority of Sauvages and Cullen,
5, Tetanus. Permanent and rigid fixation of many or all the
voluntary muscles ; with incurvation of the
body, and dyspnoea.
Tetanus. Auct. Grmc. et Recent.
Akhezet. Arab.

K Anticus. Tetanus of the flexor muscles : body rigid-
ly bent forward.
Tetanus anticus. Bontii. Med. Ind.
£in[)rosthotonus (if*7rfo(rQoT$vo?.) Cal, Aur, Sennert. et
Auct. Alior.
C Dorsalis. Tetanus of the extensor muscles : body
rigidly bent backward.
Tetanus dorsalis. Journ.de Med. Oct. 1761.
Opisthotonus {oTrnrioTovoi.) Aret. et Auct. Alior,
y Lateralis. Tetanus of the lateral muscles: body rigid-
ly bent laterally.
Tetanus lateralis. Fernet. Sauv.

5. Entasia Tetanus. Tsravos, " extensus :" from T«ya, or Ttretita :
•'tendo; extendo " So emprosthotonus from i/ATr^otrhv, "ante,"
and T«v«, as above. As also opisthotonus, from tTriaim " pone," and
Tt/v*». According to Celsus, all these terms have been used synony-
mously: opisthotonus having been earliest employed among the
Greeks, then emprosthotonus, and lastly tetanus, as the name for
the present species : while some writers used each of them In a
looser sense, so as to embrace various other species as well. " Pri-
orem Grseci o7ria-6oTav<» sequentem ifjLTr^oadorovov., ultimum nrxvty, ap-
pellant ; quamvis minus subtiliter quidam indiscretis his nominibus
utuntur." Lib. iv. c. 3.

264 NOSOLOGY. [CL. IV.-OR. ill.

5 C&tochus. Tetanus general, with little or no difficult
ty of breathing ; chronic and periodical.
Catochus. Sauv. Fog, Sag. Macbr.

Produced ordinarily from the same causes as tris-
mus ; and found also, occasionally, as a symptom, in
syphilis and worms.

Catochus is commonly regarded as a variety of
tetanus; but more usually, perhaps, occurs as a varie-
ty of carus Ecstasis, Gen. II. Ord. iv. of this class : be-
ing seldom without the concurrent action or affection
of other branches of the nervous system, besides the
voluntary muscles.
6. AcROTiSMUs. Failure or cessation of the pulse ; with little or
no disturbance of perception or voluntary
power.
Asphyxia, seu Defectus Pulsus. Plouquel.
« Universalis. Extending over the whole arterial sys-
tem.

See Mr. J. Hunter's affection in SirEverard Home's
life of him, prefixed to his Treatise on Inflammation,
p. xlvi, consisting of a total suspension of pulsation
for nearly an hour, with cessation of involuntary
breathing for the same time: countenance pale and
ghastly ; faculties of the mind, and power over the
voluntary muscles perfect: internal stimulants useless.
Connected with sternalgia.

Similar suspensions of pulsation, without any other
affection of the system. Anecdotes de Medicine^ p.
199. Marcell. Dora. lib. VI. cap. ii. p. 620, ex Malth.
de Grado. — For seven days, without other aftection.
Riodlin, Lin. Med. 1696, p. 48. — Seven days before
death. Valisneri, 0pp. III. p. 278. — Chronic, and
continuing through the whole term of life. Berryat
Hist, de I'Acad. des Sciences a Paris, 1748.

2. Entasia Acroiismus. ^Ax^orta-fcti^ " defectus pulsus," from
teg«r«$ "pulsus;" whence crotophos or crotophium, "a painful ptd-
sation or throbbing in the temples." Asphyxia would have been
the Uirm employed for this species, as it is by Plouquet, but that it
has been long a{)propriated to import suspended animation or appa-
rent death ; — a total cessation, not of the pulse only, but of sense
and voluntary motion. The disease has never hitherto, that the
author knows, been noticed by nosologists : but the cases are so
clear and numerous, that the omission ought no longer to continue.

GE. II.J iNObOLOGY, 265

C Particularis. Confined to particular parts of the ar-
teral system.

Over the whole system except the heart, which pul-
sated violently. Beggi in Pachioni opp. — Confined
to the arteries of a single arm. Camerar. Memorab.
Cent. II. p. 54.

Sometimes the result of aneurism or partial para-
lysis.
7. Systremma. Sudden and rigid contraction and convolution
of one or more muscles of the body ; mostly
those of the stomach and extremities, vehe-
mently painful, but of short duration.
Crampus. Sauv. Vog. Sag.
Tetanus dolorificus. Dane.
Taus. Arab.

Fekek. Of Persian origin.
Crampfr. G.
Granchio. llal.
Crampe. F.
Cramp.

Chiefly produced by a sudden chill, as that of the
night air, or of water when swimming in it ; often occa-
sioned by an uneasy position, or undue distention of the
muscles: and hence frequently attacking in sleep.

Found also, as a symptom, in cholera ; and occasion-
ally in pregnancy and during labour.

UENUS II.
NEURALGIA.*

Contraction and distortion of a particular muscle or group
of muscles, with partial trepidations, and acute lanci-

7. Entasia Systremma. 'Zvar^ifAfisc,., " contortio," " convolutio,"
" coagumentum compactile," " globus :" from o-ys-gs(p», " contorquQp,"
" convolvo in fascem." Stremma^ the primary noun, is already fa-
miliar to the medical ear in the sense of " strain, twist, wrench ;"
see CI. VII. Ord. I. Gen. ii, 3. And hence it is already prepared

[* In the ''■ Studij of Medicine,'" Neuralgia is the 6th genus, 2d order, 4th rla?:-
See " Studv of Medicinr." Vol. HI. p. 192.]
34

^66 NOSOLOGY. [CL. IV.-OR. III.

nating pains in the course of the principal nerves :
paroxysm short, recurrin:'; at irregular periods.

1. FACIEI. Contraction and distortion seated about the ala nasi

and upper lip; pains shooting to the orbit: often
to the ear, and over the cheek, palate, teeth, and
fauces.

Trismus maxillaris. — T. dolorificus. Sauv.

Dolor crucians faciei. FothergilL

Hemicrania idiopathica. Darw,

Autalgia dolorosa. E. Young.

Tic douloureux. Andre. FothergilL

2. PEDIS. Racking and intolerable pain seated about the heel ;

tremulously shooting in irregular directions to-
wards the ancle and bones of the tarsus.

This species is described from a very marked
case which has lately occurred to the author, in a

for systremma, in the sense of crampus^ a term intolerably barbarous
and universal]}' reprobated, though to this hour in universal use,
notwithstanding such reprobation. The proper Latin term perhaps
is raptus nervomm ; whence opisthotonia, or opisthotonus is ''^ raptus
supinusP''

Gen. II. Neuralgia. From ytvgsy, " nervus," and «»Ay«j, "dolor.'-
The only species that has hitherto been fully described is that which
attacks the face — n. faciei of the present method, consisting in a
morbid affection of some of the branches of the fifth pair of nerves,
constituting very generally the sense of feeling ; and for a very ex-
cellent description of which the reader may turn to Mr. J. Hunter
on the " Animal Economy," p. 259.

Andre appears to be the earliest writer who remarked this pain-
ful affection with accuracy. He succeeded in removing it perma-
nently by applying a caustic to the infra-orbitary or maxillary branch
in one case, in vvhich a previous division of the nerve by the scal-
pel, as practised by M. Marechal, had produced only a temporary
cure. Dr. Haighton, however, seems in one instance of a later
date, to liave found the last method also radically successful.

But perhaps the most curious and complicated example to be met
with is that of Mr. Bosworth, a patient of Dr. Darwin's, and who
was operated upon successively by Mr. Cruikshank and Mr. Thom-
as. In this case the disease appears to have existed in almost eve-
ry branch of the affected nerve, and also to have passed into one
or two others, or, to have influenced them by sympathy. By a dex-
terous and repeated use of the knife, however, carried into different
directions, this formidable and intricate disease was at length radi-
cally cured, and the patient in consequence perfectly restored to
ea^e. The account is given in Dr. Darwin's Zoonomia, Part II.

GE. in.] NOSOLOGY. 267

gentleman, otherwise of good health, about forty-
five years of age, who has been long a victim to it.
The pain during the paroxysm is so severe as
nearly to make him faint, and is generally com-
pared by him to that of scalding verjuice poured
over a wound. Here the tibial branch of the
ischiatic nerve seems to be aftected, and perhaps
the peroneal.

GENUS III.

CLONUS.

Forcible agitation of one or more muscles in sudden and ir-
regular snatches.

Diseases of Irritation, CI. I. ii. 2. 12, in two interesting letters : the
first from the author of the work to Mr. Cruilishank, and the second
from Mr. Thomas, his son-in-law, in reply.

Darwin properly enough objects to the word trismus., under which
this genus has commonly been arranged, " as no fixed spasm like
the locked-jaw exists in this malady." He adds, indeed, that in the
few cases he has witnessed there has not even been any convulsion
of the muscles of the face ; though this he subjoins " may possibly
occur occasionally as the consequence of disagreeable sensation, or
to relieve it."" — Almost every writer however, besides himself, has
noticed the existence of some kind of nervous contraction, distor-
tion, or agitation, from the commencement of the disease ; and in
the case of Mr. Bosworth, Dr. Darwin expressly observes, that dur-
ing the return of the pain " he seems to stretch and exert his arms,
and appears to have a tendency to epileptic actions," — clearly
evincing a spasmodic diathesis.

The word <ic, of late introduced from the French writers into our
own language, is supposed to be an onomaptopy, or a name fabri-
cated for the purpose : derived, according to some, from the pun-
gent stroke with which the pain assaults, resembling the bite of an
insect; but according to Sauvages and Soleysel, from the sound
made by horses that are perpetually biting the manger when la-
bouring under a Vririety of this disease. We do not appear to be
acquainted with the real origin of the term.

Gen. III. Clcvus. KAe»es, KAevjj<r<f, " agitatio," " perturbatio,"
from xAo>{«, " commoveo," '• concutio." The clonic or concussive
spasms form two distinct orders in Sauvages, and a single genus in
Parr. The first is unnecessarily diffuse ; the second too restricted.

268 NOSOLOGY. [CL. IV.-OR. III.

Clonici partiales. Sauv. j»

1. Singultus. Convulsive catch of the-*i^espiratory muscles,
with sonorous inspiration; iterated at short
intervals.
Lygmus (Auy(t««j.) Hippocr. et Auct. Gnec. See FreiruVs

Transl. lot. p. 181.
Singultus. Auct. Lat. et Meoter.
Fevak. Arab.
Glucksen. G.
Hoquet. F.
Hiccough.

Sometimes periodic. Bonef^ Sepulchr. lib. iii. S. V.
Obs. 4. — Sometimes chronic ; and has continued three
months. Schenck, lib. iii. 49 : — Four years. Bartholin,
Hist. Anat. Cent. II. hist. 4. — Twenty-four years. Al-
herti, Dissert. Casus singultus chronici. Hall, 1743..

Occasionally idiopathic ; but more frequently found,
as a symptom, in various affections of the stomach, ex-
cess of food, worms, strangulated hernia, atonic fevers,
hypocondrias, and local irritation after operations.
See Hunter on Blood, p. 410.
% Sternutatio. Irritation of the membrane of the nostrils,
producing sudden, violent, and sonorous
expiration through their channel.
Ptarmus {■^ru^ftog.) Auct. Grcec.
Sternutatio. Auct, Lat.
Otas. Arab.
Niesen. G.
Eternuement. F.
Sneezing,

At times periodic. Brest. Sanimlung. 1725. ii. B^2,
Eph. J^at. Cur. Cent. V. Obs. 1 9. — Of long continuance,
Horstii Opp. ii. 298. — Three hundred times in a parox-
ysm. Eph. Nat. Cur. Dec. i. ann. iii. obs. 138.

Fach order ol Sauvages is reduced, in the present attempt, to a dis-
tinct genus ; to the former the well known and appropriate ternn
clonus is still applied, to the latter synclomis, which see.

3. Clonus Palpitntio. The disease, in one or two of its varie-
ties, is accurately and ably described by Mr. Dundas in the Trans-
actions of the Medico-Chirurg. Society^ Vol. I. p. 37; who gives ma-
ny interesting cases which he regards as having been " always the
con.sequence of, or connected with, rheumatic affection." These
cases chiefly relate to the variety y, and were complicated with

GE. III.] NOSOLOGY. 269

Found als^ Frequently, as a symptom in measles, ca-
tarrh, and wbrms : and said to produce a periodical va-
riety,
3. Palpitatio. Irregular and vibratory motion of the heart or
arteries.
Palpitatio. Auct. Lat. et Neoter.
Palmus (Tretxuci) duct. Grcec.
Khefakan. Arab.
Klopffen. G.
Palpitation. F.
Palpitation.
« Cordis. Of the heart alone.

The palpitation has sometimes been sonorous. Cas-
tell (P. V.) Exercit. ad effect, thoracis. Tr. IX. To-
losa 1616. — A Vega, de arte Med. So violent as to
dislocate the ribs. Horst. ii. 137. 139. — To break
them. Schenck. Obs. 215 ex Fernelio — Victorius, Con-
sil. n. 97. In like manner the humerus has been dis-
located by a convulsion fit. See exarthreraa and
catagma Fractura, Class VII. Ord. I.
C Arteriosa. Of the arteries alone.

A few very decided cases of this variety have oc-
curred to the author ; and probably many more to
others. The anomalous motion could be easily felt
by pressing the finger on the arteries subject to it,
and, in one instance, distinctly seen.

Universal. Ephem. Nat. Cur. Dec. I. ann. vi. vii.
y Complicata. Extending from the heart more or less
through the course of the arteries.
Found, also frequently, as a symptom in organic
affections of the heart, and violent mental emotions.

4. NiCTiTATio. Rapid and vibratory motion of the eyelids.

Nictitatio. Auct. Lat.
Nystagmus (v«s-T«y^«5.) Auct. Gnu.
Blinzen der ^ugenlieder. G.
Souris. F. Diet, de Med.
Twinkling of the eye-lids.

5. SuBsuLTUs. Sudden and subsultory elevations of the tendons.

great anxiety, usually with dyspnoea, with palpitation, or violent
pulsation of the carotid arteries ; and sometimes with an " action of
the heart so very strong as to be distinctly heard, and to agitate the
bed the patient was in so violently, that the pulse of the patient
could be counted by looking at the motion of the curtains of thn

270 NOSOLOGY. &^ . [CL. IV.-OR. Ul-

Subsultus. Linn, Sag. ' ^.

Carphologia spasmodica. Sauv.
Soubresaut des tendons. F,
Twitching of the tendons.

The instances of idiopathic affection are not common,
though the author has sometimes met with them. The
usual irritation is that of debility ; and hence it is found,
far more frequently, as a symptom in arthritic and hy-
steric affections, and particularly in atonic fevers.
6. Pandiculatig. Transient elongation of the extensor mus-
cles, with deep inspiration and sense of
lassitude.
Pandiculatio. Aiict. Lat. et Ntoter.
Scordinema. Hippocr.
Nehva. Arab.
X Maxillarum. Of the jaws.

Oscitatio. Auct. Var.

Gahnen. G.

Baillement. F.

Yazvning. Gaping.
C Arluum. Of the limbs.

Streckung. G.

Tiraillement. F.

Stretching.

Found also, frequently, as a symptom in fatigue,

hysterics, restlessness, dyspepsy, and the accession

of fevers. As an idiopathic affection, acquired chiefly

from a habit of idleness.

GENUS IV.

SYNCLONUS.

Tremulous, simultaneous, and chronic agitation of various
muscles, especially when excited by the will.

bed " On dissection, the heart was uniformly found enlarged in its
size, but without increase of muscular power : occasionally poly-
pous concretions were detected, and very generally adhesions to
the pericardium. The above patients were mostly in the prime of
life.

GE. IV.] • ^ NOSOLOGl. 271

Clonici universales. Sauv.
Clonus. Young,

1 . Tremor. Simple, tremulous agitation of the head, limbs, or

both ; mostly on voluntary motion.
Tromus (rg^^ej.) Auct. Grac,
Tremor. Sauv. Linn, Vog, Sag. Cull.
Raush. Arab.
Lerze. Pers. It imports also the rigor that takes place

on the accession of an ague. In which last sense the

Turkish writers use ditreme, as though derived from

T^«M«$, or tremor.
Zittern. G.
Tremblement. F.
Trembling.

Found also, occasionally, as a symptom, in debility,
old age, surfeit, and other affections of the stomach,
passions of various kinds, paralysis, metallic poisons,
and worms.

2. Chorea. Alternately tremulous and jerking motion of the

face, legs, and arms, especially when volunta-
rily called into action ; resembling the grima-
ces and gestures of buffoons; usually appearing
before puberty.

Scelotyrbe. Qtilen. Isagog. libr. fin. Sauv.

Chorea. Linn. Cull.

Chorea Sancti Viti. Sydenh.

Choreomania. — Ballismus. Plouquet.

Gen. IV. SvNCLONUs. From avyKXenu, " concutio," " conturbo ;"
as clonus from xX*fia. The genus, as observed in the preceding
note, is designed to include all the clonici universales of Sauvages,
that seem fairly to belong to the same family. It runs nearly paral-
lel with the clonus of Dr. Young, who has emploj'ed the term in a
sense more than commonly restricted.

2. Synclonus Chorea. Xafo?, " chorus," " ccetus saltantium " Ac-
cording to Horst, the name of St. Vitus's dance was given to this
disease, or more probably to a disease possessing some resemblance
to it, in consequence of the cure produced on certain women of
disordered mind upon their paying a visit to the chapel of St. Vitus
near Ulm, and exercising themselves in dancing from morning to
night, or till they became exhausted. He adds, that the disease re-
turned annually, and was annually removed by the same means.
Macbride has hence given to it the name of hieranosis, by other
writers applied to syspasia or convulsion-fits.

272 NOSOLOGV. [CL. IV.-OR. HI.

Danse de St. Guy. F.
Su Vitus's Dance.

Sometimes with deep and continued melancholy.
Thkrmal. Consil. lib. ii. p. 14. — Stoll strongly recom-
mends the extract of belladonna, obtained from the
juice of its roots, every four hours, in the proportion of
from a sixth part to a quarter of a grain. Dr. Hamil-
ton has found his purgative system peculiarly service-
able. See his treatise " On the Utility of Purgative
Medicines, &c." 1805. Cured by the arsenic solution,
at a medium dose of ten drops three times a daj*", in a
girl of fourteen, after digitalis had been tried in vain.
Martin. Trans. Medico-chir. Soc. iv. 45.
3. Raphania. Spastic contraction of the joints ; with trembling
and periodical pains.
Raphania. Linn, Vog. Cull.
Convulsio Raphania. Sauv.
Kriebel-Krankheit. G.
Dragsiuta, Suecic.

Sometimes accompanied Avith cutaneous ulcerations,
and extensive exfoliations of the cuticle and cutis. See
Taube Geschichte der Kriebel-Krankheit, Gottingen,
1782.

3. Synclonus Raphania. So called by Linneus as being supposed
by him to be produced by eating the seeds of raphania, Raphanis-
trum. It is chiefly found in Sweden and the adjoining countries;
and has hence been chiefly treated of by Swedish writers. There
is an excellent paper upon the subject by Dr. Rothman,in the Arnce-
niiates Academicce^ Vol. VI. ; who asserts, that it is neither a new
disease, nor confined to the Baltic countries. He has traced it, he
says, as an affection common to Europe, in the works of various
writers up to the year 1596. It seems to depend upon some delete-
rious vegetable intermixed with the grain employed in making
bread: some species of lollium, or secale ((/arne/ or rye) have been
suspected ; but there is more reason for ascribing it to the raphania,
Raphanisiru7n.

4. Synclonus Bcriberia. hi^Zi^i, Eustalh. " concha," " ostreum ;'*
a " conch or shell ;" and hence figuratively incurvation in general. —
It is unquestionably an oriental term, and is so stated by Eustathius;
from whom Scapula bas copied it. Possibly the root of the term is
the Arabic, fcert, which signifies literally " praecido, concido," " to
cut up or cut off," — like the Greek crvyKOTrru., whence syncope ; and
metaphorically " defatigo, exhaurio," " to wear out, exhaust, en-
/eeble." The author has retained it as it is given in Scapula, not-

GE. IV.] NOSOLOGY. 273

4. Beriberia. Spastic retraction of the knees on walking 5
trembling and painful stupor of the limbs ;
sense of formication ; hoarse voice.

Beriberi. Bonlii, Mariget. Linn.

Beriberia. Sauv. Sag.

Paralysis Beriberi. Tulpius.

O R J) E R IV
SYSTATICA.

iFFECTING SEVERAL OR ALL THE SENSORIAL POWERS SIMULTA-
NEOUSLY.

Irritation or inertness of the mind extending to the muscles
or external senses; or of the muscles or external senses
extendinsr to the mind.

withstanding that Sauvages has introduced it into his hst of"nomina
barbara, sen nee Grasca, nee Latina, relinquenda." Tom. I. p. 30.
Mangetus asserts that it was known to Erasistratus.

The term is still preserved in Ceylon, but applied to a different
disease : a peculiar sort of dropsy, commencing with stiffness and
oedema of the lower extremities, which shortly spread over the
whole body, producing dyspnoea, vomiting conclusive motions, and
death. The symptoms have been given at some length by Mr.
Colhoun and Mr. Christie, inspector-general of the hospitals in Cey-
lon. The English forces established at Ceylon are occasionally
subject to it. See "Essay on the Diseases incident to Indian Sea-
men or Lascars on long Voyages." By William Hunter, A. M.
Member of the Asiatic Society of Calcutta, &c. In like manner
Lord Vrilentia, in his Travels, Vol. I, p. 318: "a complaint, as far
as I have learnt, peculiar to the island (Ceylon) is the berri-berri.
It is in fact a dropsy that frequently destroys in a few days."

In whatever form it conducts its attack, it appears, like the pre-
ceding, to be the result of food or drink poisoned by some minute
parasitic plant or animalcule, as in the case of gangra;na ustilaginea,
and various examples of pestis erythematica ; to the notes on both
which the reader may turn.

Order IV. Systatica. ^EvrretTtxx, " congressa," " consociata,"'
" concidentia :" frotn a-vvttTTvifAi, " congredior," " consocio." Syncop-
tica might have bfeen employed, and upon as large, a scale, import-

35

274 ISOSOLOGt. [CL. IV.-OR. IT.

GENUS I.

AGRYPNIA.

Difficulty or inability of obtaining sleep.
Agrypnia. Auct, Grcsc. Sauv, et recentior.
Pervigilium. Auct. Lat.
Arek. Arab.
Schlaflosigkeit. G.
Insomnie. F.
Sleeplessness.

1. ENTONicA. Sleep retarded by an inordinate excitation of the

mind to a particular subject : listlessness to
surrounding objects.

2. CHRONICA. Habitual wakefulness ; mind tranquil ; attention

alive to surrounding objects.

See Gooch^s Observations, App. p. 218. — •
Thirty-five days vpithout intermission. Grilling.
Cent. iv. obs. 90 — Six months. Panarol, Pen-
tecost. V. obs. 4 — Three years. Plinii, lib. vii.
cap.- 51.

Mostly common to advanced age.

Found also, occasionally, as a symptom, in
excessive fatigue, pain, inflammations, fevers,
and various mental diseases.

GENUS II
DYSPHORIA

jbl'soiiiP^nd restless uneasiness of the nerves and mus-

ing t^t^eli iucreased as diminished action, compello^ as well as con-
cic/o/ 'but that it i; "jsually Umited to the last train of ideas, andcon-
aequeotly might have produced confusion : since the present order,
like ail the preceding, includes diseases evincing different and even
opposite states of action.

Gen. I. Agrypnia. 'Ay^t/^x*, " pervigilatio ;" from ^yjwwM*,
pervigilo." " insomnem noctem due©." The genus is not gene-

GErll.] NOSOLOGY. 270

cles ; increased sensibility: inability of fixing the a*

tention.

Dysphoria. Auct, Grcec.

Inquietude. Sennert. Plouquei,

Astasia. Plouquet.

Desasossiego. Spanish.

Unruhe. G.

Restlessness,
J. SIMPLEX. General; and accompanied with a perpetual de-
sire of changing the position.

Dysphoria nervosa. Cricht.

Erethismus simplex. Young.

Kalak Arab. This term precisely answers to the En-
glish word Jidgeis. or titubatio, as used by Cicero.

Fretillement. F.

Fidgets.
2. Anxietas. Chiefly affecting the praecordia: with depression
of spirits, and perpetual desire of loco-
motion.

Aiysmus (AXvcftos.) Hippocr.

Anxietas. Sauv. Vog. Sag.

Hemm. Arab. The Persian synonym is tasa or tsesa :
nearly univocal with the Latin tizsa, whence perfcesa ;
and probably derived from a common source.

Angst. G.

Anxiete. F.

Anxiety.

Found also, occasionally, as a symptom, in acute fe-
vers, affections of the stomach, and other viscera, hyste-
rics, hypocondrias, and lyssa.

rally introduced into systematic nosology : but its claim is clear, as
in many instances it seems to be strictly idiopathic", and unconnected
with any other disease. . *'^ji-*'' v -

Gen. II. Dysphoria. At;cr^»g<«, " tolerandi ^li^cuftas,f^ frojn
2v(7(pc^Uit, '■'■ di^culter tolero^'' or '■Oporto.'''' It does not expressly''el»'
ter mto the classification of Sauvages or that of Cullen, but iij^ear-
]y synonymous with the anxietas of the former, which, in t^fe^pre-
aent system, is reduced to a species of dysphoria. " Molesia:,'i^nsa^-
tio^'''' says Sauvages, " quae ad jectigationem cogit, sed quomodo a5
affinibus morbis discrepet, dicant qui expert! sunt." This definition!,
if definition it may be called, vviil equally apply to both the specie-
here offered

^

276 NOSOLOGY. [CL. IV. -OR. IV.

GENUS 111
ANTIPATHIA.

Internal horror at the presence of particular objects or sub-
jects 5 with great external restlessness or deliquium.
Antipathia. Sauv. Linn. Vog. Plouquci.
Arbedet. Arab.
Antipathic. G. F.
Antipathy.
1. SENSiLTs. Antipathy produced through the medium of the
external senses.

Sight of a drawn sword in King James I. Digby
Thcatr. vSympathet. — Sound of music. Eph. J^at.
Cm: Dec. [. ann. i. obs. 134. — Smell of roses. Id.
Dec. II. ann. x. Obs. 8. — Of strawberries. Id.
ann. v. obs. 214. — Taste of cheese. Zacut. Lusit.
Frax. admir. lib. iii. obs. 103. Eph. Nat. Cur.
passim.

Gen. III. Antipathia. AcTiTradaij : from «»rT<?r«fle«, " naturalem
repugnantiam babeo." The instances advanced bj physiologists are
innumerable ; and many of tbem are of every-day repetition-
Some ma}' be accounted for from early frigbt, or other cause of
disgust; but many are of very difficult solution, and some altogether
intractable. The most singular, perhaps, are those of the second
species, instanced in the horror excited by a cat as soon as it comes
within the atmosphere of an unknown influence, the animal being
neither seen nor heard, nor in any respect an object of anj^ external
sense. The author has met with several decided cases. , Sauvages
inquires whether, in such instances, the effluvium thrown from the
object of disgust into the atmosphere, may not, in combining with
the fluids of the influenced person, produce a teriiurn quid, as cor-
rosive sublimate is produced by a combination of mercury with mu-
riatic acid. The fact at present appears inexplicable : but il is not
more singular than the wonderful power so well known to be pos-
sessed by the viverra noctula (common or great bat,) which renders
it conscious of the presence and position of objects, when all its
senses arc muffled ; and which enables it, when flying in this state,
to avoid them. This extraordinary faculty has been called a sixth
sense by several naturalists.

Antipathia does not occur in Dr. Cullen's classilication : but it en-
ters uito his supplementary catalogue " morborum a nobis omisso-
I'um, quos omississe fortassis non oportebat."

GE. IV.] NOSOLOGV. 277

2. Insensilis. Antipathy produced through an unknown medium.
Chiefly in the case of cats, at hand, but neither
seen, touched, smelt, or heard. See Smetius, Mis-
eel, p. 101. Bartholin. Hist Anat. Cent. III. 28.
Cent. IV. 58. Quercetan, Diaet. Polyhist. p. 82.
Eph. J^at. Cur. Dec. IJ. ann. ii. obs. 50.

GENUS IV.

LYSSA.*

Great restlessness ; anxiety ; hurry of mind ; horror ; and
constriction of the muscles of the chest ; supervening to
the bite of a rabid animal : preceded by a return of
pain and inflammation in the bitten part.
Lyssa. ^ucf. Grcec.
Rabies. Auct. Lat.
Keleb. Arab.
Rage. F.

Not always accompanied with water-dread ; in dogs :
Salmuth, Cent. III. obs. 90. — In wolves : TrecoiirL Me-
moires et Observations de Chirurgerie. In man : — able to
take fluids before death : Observ. Clinic. Fasc. II. p. 48.
Able to eat and drink : Ditndas^ Lond. Med? Journ.
VIII. p. 1, 1787, the case doubtful. See also Fe/i?-. Na-
chricht, &,c. p. 44.

The academical journals and monogrammic writers have
numerous instances of the disease after a bite of many
years standing: sometimes twelve, eighteen, or twenty:
but the cases want authority. In Heister is a case of lyssa
produced by putting into the mouth the cord by which the
rabid dog had been confined. Wahrnemungen, Band II.

Gen. IV. Lyssa. Avervec, " rabies," whence T^vaaotta, " furo ;'"
probably from Av*, " solvo." T he old Greek term is here restor-
ed, as far more correct than that of the present day, which is luj-
drophobia or water-dread^ since the last is not a pathognomic symp-
tom ; being sometimes found in other diseases; occasionally ceasing
even in canine madness, the second species here offered, towards
the close of the paroxysm; and though almost always found among
mankind, in numerous instances wanting in rabid dogs and wolves.

* [In the " Study of Medicine," Lyssa is hot ranked as a genos, but is the 7th spe-
cies. 1st fxenns. 3d oider, 4th class. See " Study of Medicine. Vol. TTI. p. 22R.]

278 NOSOLOGY. [CL. IV.-OR. IV.

In Dr. Marcet's case, Medico-chir. Trans. I. 1 32, the
patient lived six days after the appearance of water-dread.
Opium, iron, and arsenic, were tried in large quantities,
but proved equally ineffectual.

On dissection, the fauces, glottis, larynx, oesophagus,
and stomach, have been commonly found more or less in-
flamed ; sometimes abraded.
1. FELiNA. The paroxysm periodical, and returning with the
full moon : produced by the bite of an enraged
cat.
Anxietas a morsu. Sanv.

Anxietas a morsii felis iratae. Morgagn. ep. Ixi. 1 4.
Feline madness.

In the case here referred to, the paroxysm took place
four days after the bite : there was great anxiety of the
prascordia, but no water-dread. Local and general
bleedings were useless ; frequent repetition of the warm
bath afforded relief; but it only yielded to an ephemera
with copious sweat. It returned with the full moon for
two years : the bitten part first becoming highly irrita-
ble ; and the general symptoms succeeding, which were
now relieved by bleeding. After this period it returned
with every fourth full moon for two years more. — See
another case, which terminated fatally on the first pa-
roxysm, in the Trans. Med. Soc. of London^ Vol. I. p. 78.

" Constat repetita," says Sauvages, " apud Gallo-provinciales expe-
rientia, canes luposque rabidos bibisse, manducasse, flumen tranasse,
ut olim Marologii el bis Forolivii observatum, adeoque nee cibum
nee potum aversari." According to Mejnell, tbe disease, among
dogs, appears from ten days to eight months after the bite. In
Earl Fitzvvilliam's hounds, which were bitten June 8, 1791, the in-
terval varied from six weeks to more than six months. Among
mankind its accession is also very uncertain, as this seems to be re-
gulated by the time of the year, the habit of the patient, and other
accidental circumstEfnces. It has occurred a fortnight after the bite,
three weeks, a month, and sometimes six weeks, and even three
months, after which last period the patient is considered safe.

In two cases published by Dr. Thacher in the American Med. and
Phil. Register, Vol. I. p. 4.57, the injury inflicted by the same dog,
Aug. 16, 1810, did not produce hydrophobia till nearly three months
afterwards, Nov. 3, and Nov. M : the first case was that of a child
under four years of age, the second that of an old man of seventy-
three. In the former the hydrophobia continued for six days, and
in the latter for seven, before dealh ensued. The remfdies chiefly

GE. v.] NOSOLOGY. 279

% CANiNA. The constriction extending to the muscles of de-
glutition ; which are violently convulsed at the
appearance or idea of liquids : produced by the
bite of a rabid dog, and fatal on the first pa-
roxysm.

Pantophobia. Cal. Aur.

Rabies canina. Boerhaav.

Hydrophobia. Sauv. Linn. Sag. Cull.

Erethismus Hydrophobia. Young.

Clonos Hydrophobia. Parr.

Hund-lollheit. G.

Hydrophobia. F.

Canine madness.

GENUS V.

CEPHALiEA.

Aching pain in the head ; intolerable of .light and sound ;
difficulty of bending the mind to mental operations.
Sedao. Jrab.

recommended in America are lobelia inflata, Scutellaria latiflora,
auagaWis arvensis in the form of tincture. Dr. Hossack frankly con-
fesses he has no confidence in any of them. Id. p. 462.

In the Memoirs of the Manchester Society, Vol. IV. is a singular
case published by Dr. Bardsley, of an attack of lyssa twelve years
after the bite of a dog supposed to be mad. The patient difd in
the Manchester Infirmary with the most decided symptoms of the
disease. From the long interval between the bite and the symp-
toms, Dr. Bardsley is more inclined to ascribe the disease to several
existing circumstances at the time of its appearance, and particular-
ly to a deep depression of spirits and strong mental agitation the
patient had for some time been labouring under, than to any canine
poison which might be lurking in the constitution. But this would
be to suppose that lyssa is capable, under particular circumstances,
of being spontaneously generated even in the human frame, while
Dr. Bardsley contends that it cannot exist even among dogs^ except
by contact.

Dr. CuUen, in his definition of canine madness, which he calls
hydrophobia rahiosa^ has introduced mordendi cupiJitas, " an eager
desire of biting," as a symptom. This is incorrect, and has been
consequently omitted by most succeeding nosologists.

Gen. V. Cephal^a. K8(p«/(»««, from xi^KAn, " caput," the head.

280 NOSOLOGl. [CL. IV.-OR. IV.

Hauplwehe. G.
Mai a la tete. F.
Head-ache.

1. GRAVANS. Pain obtuse; with a sense of heaviness extendino;

over the whole head : sometimes intermittent.
Ecplexis {tx.7tM%n.) Hippocf.
Cephalalgia. Sauv. et Auct. Recentior.
Etourdissement. F.
Stupid Head-ache.

2. iNTENSA. Pain vehement, with a sense of tension over the

whole head ; periodic : often chronic.
Cephalaea. Galen. Sauv. et Auct, Recentior.
Chronic Head-ache.

3. HEMicRANiA. Pain vehement : confined to the forehead, or

one side of the head : often periodic.
Hemicrania. Sauv. et Auct. Recentior.
Shekykat. Arab.
Migraine. F.
Megrim.

4. puLSATiLis. Pain pulsatory, chieiiy at the temples ; often

with sleeplessness and a sense of drumming
in the ears.
Crotaphus. Ccel. Aurel.
Cephalalgia pulsatilis. Sauv.
6. SPASMODICA. Pain partial, spasmodic ; often shifting from
one portion of the head to another; chiefly
commencing in the morning; with sickness
and faintness.

The term is applied by Galen chiefly to the chronic head-ache,
whence cephalalgia has been invented, in later times, to express af-
fections of shorter duration. The whole, however, form a natural
group, and should be included under one genus, which is here
named after the oldest and most authorized term. Sauvages has
particularly noticed the symptom of disability of the mental powers
in c. gravans^ aVid the remark maybe applied to all the other species,
"difficultas cogitandi, distinctc raliocinandi, reminiscendi.'" ('. spas-
wodica is possiljly a variety of one or two of the rest ; it is intro-
duced chi« fly upon the authority of Dr Folhcrgill.

Linneus is said to have cured himself of a severe and obstinate
iiem. crania, which returned at the interval of a vveek, and continued
lor Ivventy-four hours, by the daily use of morning exercise, preced-
ed l)y a draught of cold water. Aman. Acad. Vol. VII. art. 125. C.
l-ado. See also i\Iaton's edition of Pulteney'sLife of Linneus, p. 451.

GE. VI.] NOSOLOGY. '2ii I

Cephalalgia spasmodica. Fotherg.
Sick Head-ache.

Most of these species found also, at times, as bjuij.-
toms of other diseases : chiefly rheumatism, suppressed
catamenia, dyspepsy, and other affections of the sto-
mach ; and various fevers.

GENUS VI.
DINUS.

Apparent gyration of objects with hebetude of the senso-
rial powers.
Dinus (S/»«f.) .^MC^ Grcec.
Dizziness,
1, Vertigo. Dizziness ; sense of undulation in the ground :
unfitness for mental exertion.
Vertigo. Sauv. Linn. Vog. Sag.
Hullucinatio Vertigo. Cricht.
Autalgia Vertigo. Young.
Devar. Arab.
Schwindel. G,

Vertige. Tournoyement de tete. F,
Szciinming of the head.
-2. iLLUsoRius. Dizziness, with dimness of sight, and imagina-
ry objects before the external senses.

Gen. VI. Dinus. A/mj, " turbo," " gyrus." The species en-
tered under this genus are generally regarded as mere varieties or
degrees of the same affection : but there are few practitioners,
perhaps, who have not seen each of them commence and terminate
separately ; and consequently without running into one another, or
having any necessary connexion. Linneus has hence made scoto-
ma, not merely a different species, but a different genus from verti-
go, which is perhaps to carry the distinction too far.

The vertigo of Dr. Crichton (JVfe/U. Derangem. II. 343,) seems (o
be not essentially different from that of the present genus. His de-
finition is '' apparent rotatory motion of external objects, and sense
of undulation in the ground, with abolished attention and thought."
By him it is placed as a species under the genus hallucinatio. The
present seems to be its more proper place. It is singular that this
excellent writer should have passed by this genus in his General
Table.

f^6

282 NOSOLOGY. [CL. IV.— OR. IV.

» Phantasmatum. Ocular or auditory spectres in the
semblance of net-work, dark spots, dazzling or rain-
bow hues before the eyes ; murmuring or whizzing
in the ears.
C Mutationis. Real objects changed in their natural
qualities, by error of form, of motion, or of number.
This species has a near resemblance, in many of
its symptoms, to paropsis illusoria and paracusis
illusoria, CI. IV. Ord. II. which see. It differs
in the general affection of the head, and the evan-
escency of the disease.
3. Scotoma. Dizziness with blindness and tendency to swoon;
often succeeded by head-ache.
Scotomia. Linn.
Serkerd. Of Persian origin.
Blind Head-ache.
J^ervous Fainting-fit.

Most of the species found also, occasionally, as symp-
toms, in plethora, worms, and other affections of^the in-
testinal canal, hypocondrias, hysterics, and lues.

GENUS VII.

SYNCOPE.

Motion of the heart and lungs feeble or imperceptible ; dimin-
ished sensibility; inability of utterance.
Leipopsychia. Hippocr.
Apsychia. Gal.
Lipothymia. Plouquet.
Syncope. Sauv, Linn. Sag. Vog. Cull,
Ceshye. Arab.
Ohnmacht. G.
Evanouissement. F.
Svanimento. Span*
Szvoon.
Fainting-fit.

Gen. VII. Syncope. Swy*»?r»), from <ri»y«e7rT«, " concido," /o /e/Z
or cut down. Dr. Cullen's definition is as follows : " Motus cordis
imminutus, vel aliquamdiu quiescens." This is by no means suffi-

GE. VIII. J NOSOLOGY. 283

1. cARDiACA. Returning at irregular periods : occasional pal-

pitation of the heart during the intervals.

« Plethorica. From surcharge of the cardiac, or neigh-
bouring blood-vessels.

C Vitioso. From polypous concretions, or other mor-
bid affection of the cardiac or neighbouring blood-
vessels.

2. iNANiTioNis. Accompanied with a sense of inanition, and ex-

treme general debility,
« A fame. From hunger or long fasting.
C Afluxu. From sudden and immoderate flux, wheiher
of blood, pus, or any other fluid.
«. DOLORis. Preceded by pain or irritation of body.

« Interna. From internal pain or irritation ; produccrl

by poisons, worms, or other similar causes.
C Externa. From external pain or irritation ; produc-
ed by wounds, or other accidents or injuries.
4. PATHEMATicA, Preceded by the exercise of some sudden and
overwhelming passion.

See Amat.Lusit. Cent. VII. cur. 1. Pla-
ter, Obs. II. 431.
b. METASTATiCA. Accompanied with retrocession or repulsion
of gout, exanthems, or other diseases.

Found also, occasionally, as a sj^mptom
in hysteria, antipathia, scurvj'^, anr! fevers
of various kinds.

GENUS VIII.
SYSPASIA.

Clonic spasm; diminished sensibility; inability of utte-
rance.

ciently express : for the heart has been sometimes totally void of mo-
tion without syncope, as in the well-known case of Mr. John Hun-
ter. Sauvages's leipothymia is only syncope in its first attack or
mildest degree. Its character is " aubitanea et brevis virium de-
jectio, superstite pulsus vigore, et cognoscendi facultate." The
pulse is perhaps always affected in some measure, but in slight cases
it still retains a certain degree of power : the apprehension re-
mains : but the voice seems to be uniformly lost.

2}->4: NOSOLOGY. [CL. 1V.--0K. IV.

1 . CoNvuLSio. Muscular agitation violent ; teeth gnashing ;
hands forcibly clenched ; transient.
Convulsio. Boerh. Sauv. et Auct. Var.
Convulsio clonica. Etmull.
Nezaruh. Arab.
Convulsion. G. F,
Convulsion-fit.

ec, Erratica. Shifting irregularly from one part to an-
other.
S Universalis. Attacking every part simultaneously :
occasionally protracted or habitual,
llicranosos. hlnn. Vog.
y Intermittens. Returning after intervals regular, or

iri'egular.
S Ejulans. Accompanied with shrieks or yellings, bur

without pain,
a Infantium. Occurring in infancy ; sensibility nearly
suspended ; features of the face for the most part
hideously distorted.
Eclampsia. Sauv.

The varieties arc altered from the species in Sau-
vagcs, who has given cases of each: as well as many
others which are only symptomatic. See Sauv, TI.
550—556.

The disease, in some of its varieties, found also
occasionally as a symptom in teething, worms, and
other intestinal irritations, in affections of the kidneys,

GE^. VIII. SyspAsiA. ILvrTrxfft?^ vvtrvaoitt., " contractio," "con-
vulsio;" from ty«;9-;r««, " contraho," "convello." The term is evi-
dently wanted as a generic name for the three diseases that rank
under it in the present system, the symptoms of which, and, for the
most part, their mode of treatment are so accordant, as to estabUsh
the propriety of making them species of a common genus, rather
than distinct genera.

In defining convulsion-fit^ the first species, most of the nosologists
represent the faculties of the intellect and external senses as not in-
terfered with. Sauvages says, " superstite in paroxysmis animap
functionum exercitio :" Vogel " cum integritate sensuum." Dr.
Cullen is here far more correct: his words are, "musculorum con-
tractio clonica, abnormis, citra soporern ;" " an involuntary, clonic
contraction of the muscles, bordering on, but short of, lethargy."
The author believes diminished sensibility to be a constant symptom
in all the species of syspasia here enumerated, and has hence re-
garded this incident as a generir. feature.

GE. VIII.] NOSOLOGY. 285

parturition, and labour, various fevers, wounds of the
head, and other organs.
2. Hysteria. Convulsive struggling, alternately remitting, and
exacerbating ; rumbling in the bowels ; sense
of suffocation ; drowsiness; urine copious and
limpid ; temper fickle.
M^lum hystericum. Hoffm. Junck,
Hysteria. Sauv. et And. Recentior.
Mutter-beschwerung. G.
Mai de mere. Passion hysterique. F.
Hysterics. Hysteric-Jit.
X Atonica. From debility of constitution ; without any

evident proximate cause.
C Irritata. From sudden emotion of the mind, or irrita-
tion of the stomach or bowels.
^. Epilepsia. General muscular agitation, without sensation or
consciousness; recurring at regular or irre-
gular periods.
Comitialis. Plin. Gal.
Caducus. Paracels.
Epilepsia. Sauv. et Auct. Receniior.
Clonos Epilepsia. Parr.

Serau ; and vulgarly M'jinen, Arab. " demon-struck."
Fallende-sucht. G.
Mai caduc. Epilepsie. F.
Falling-sicking. Epilepsy.

« Cerebralis. Attacking abruptly, without evident cause,
except sometimes a slight giddiness. The remote

2. Syspasia Hysteria. 'Ytm^ix., from vcrn^x, uterus. Sauvages, in
his varieties (species as he makes them) of this disease, seems to
have followed Rawlinson with too close a step in his " theoria sub
tills et fallax," as Cullen seems justly to have called it : nor will the
characters he offers to distinguish hysteria from hypocondrias, hold
in every instance. His advice, however, will perhaps always be
found equally pleasant and profitable where it can be accomplished.
" Huic morbo sanando prosunt quae corpus roborant, animum re-
creant, et a morbi idea avertunt, ut exercitatio, itineratio, rustica-
tio, aut cupitorum obtensio ; virgini libidinosae matrimonium*; con-
jugi zelotypae vir fidelis ; post aerumnas fortuna prospera, si ex his
cupiditas expleatur." Vol. II. 586.

3. Syspasia Epilepsia. 'EttiXhi^ix : from g^r/Aas^SaM/s***, fut. 1.
iTs-iXn^ofAxt, " apprehendo," to seize upon. In the transactions of the
Swedish academy, there is a valuable paper of Linneus, i. 279, en-
titled " Ron, om orsakem til Fallande gotem i Skrane ock Wernsha-
rad.'" "Observations on the cause of the Falling-sickness prevail-

286 NOSOLOGY. [CL. IV.-OR. IV.

cause is external violence to, or internal injury,
malform;ition, or disease, of the head.
C Rigida. The limbs fixt and rigid, with agitation of

particular organs.
y Sympathetica. Catenating with some morbid action
of a remote part, with a sense of a cold vapour as-
cending from it to the head.
S Irritata. From sudden emotion of the mind, or irrita-
tion of the stomach or bowels.
Found also occasionally as a symptom in sup-
pressed exanthems, syphilis, fevers, and urterine af-
fections.

In one instance recurring at the sight of a hare, and
ascribed to a fright of the mother during pregnancy
from the sudden and unexpected approach of the
hare. Ephem. Xat. Cur. Dec. 11. ann. iv. App. p. 209.
Occasionally recovered from after frequent recurren-
ces for twenty-five years. Rhodii. lib. i. obs. 63.

GENUS IX.
CARUS.

Muscular immobility ; mental or corporeal (orpitude •, or
both.

Comata. Sauv.
Soporosi. Linn.

ing at Wernsharad in the province of Skrane." The disease was
common to children with scalled heads, and was supposed to be a
consequence of this eruption. Linntus seems here far more cor-
rectly to ascribe it to the ablution of the diseased head, with cold
water, acting as a repellent.

Gen. IX. Carus. K«5««, " sopor cum gravedine," deep heavy
sleep ; from *<«{«, " the head," the organ in which the disease is
chiefly seated.

The term Carus is here employed in a more extensive sense than
by most other writers, so as to include several of the species arrang-
ed by Sauvages under his two orders leipopsvchij: and comata ; near-
ly synonymously with the defectivi and soi'obosi of Linneus, and still
more with the adynamic; of Macbride. As a characteristic symptom,
torpor, or torpitude, is preferred by the author to stupor, or sopor,
on two accounts : first as being of wider signification, since it in-

GE. IX.] NOSOLOGl. 2B7

Comata vel morbi soporosi. Sag.
Coma. Parr.
Carus. Young.
Torpor.

I. Asphyxia. Total suspension of all the mental and corporeal

functions.

eludes the general ideas of both ; and secondly because neither
stupor nor sopor have been uniformlj employed in a determinate
sense of any kind. Thus stupor is often, perhaps usually, restrain-
ed to mental insensibility or morbid sleep; while Sauvages defines
it in Class Vll. Ord. 1. gen. 7, " hebetude of the sense of touch,*'
•• molestia quae sensum tactiis obscurat :'■ and Linneus, CI. VI. Ord.

II, 105, " transient sleep of any part with a sense of formication.'*
''■Sopor transitorius partis alicujus cum sensu formicationis." In this
place, and indeed generally, Linneus makes sopor combine the two
ideas of cessation of motion and of feeling, — cessation of irritability
and sensibility : while Cullen objects, and correctly, to this strained
extent of the term, and limits it to the ordinary signification of
'' sleep, or a sleep-like state :*' " pro somno vel pro statu somno si-
mili." Note on Gen. xlii, apoplexia. Torpor, or torpitude in the
above definition, imports insensibility mental or corporeal, in a frame
still alive, and actuated, though often imperceptibly, by the vital
principle : insensibility is of wider range, and is often predicated of
insentient, unorganised matter, that never possessed the principle
of life.

Torpitude thus explained will equally apply to asphyxia, («7^|;j«.
from u priv. and rf '4*«, •• pulsus ;"") ecstasis (at^TiWij, from i^urrnfUf
" de statu mentis dejicio ;'') catalepsis (*aT«Ai,4'*«, from x»Ta>Mfc-
S«M^.', "deprehendor ;*') lethargus {xn6a^*it from Ajj^u and m^y^
•'obhvio pigra ;"") apoplexia {airo^Xf^uty from ««•# and «->i|«r*», •' per-
cutio ;"' and paralysis {irtt^etXvTti, from xagaAw*. •• resolvo, debilito.*')

Some of these species are vpry uncomoion ; and a few have been
supposed doubtful : but upon the whole the authorities are in their
favour, and they ought neither to be omitted, nor too generally
merged, as they seem to be by Cullen. in the sweeping catalogue
of apoplexies, a genus, which, in his arrangement, is made to in-
clude a variety of distinct and often very diflerent diseases ; but
which he found it ditficult to distinguish' or arrange individually.
Asphyxy is here used in the general sense of the term, though h
has occasionally been employed to import mere failure or cessation
of the pulse, which in the present classification is made a species of
entasia, under the distinctive name of acrotismus. See present
class, order 11.

Upon animal life in general the electric fluid, whether discharged
trem a Leyden phial, a voltaic battery, or in the form of lightnin?.
seems to act alike in every instance, and only to vary in proportion

^^8 NOSOLOGY. [CL. IV.-OK. IV.

Asphyxia. Sauv. Linn. Vog. Sag.
Mors apparens. Lanus.
Asphyxie. F.
Asphyxy.

Suspended animation.

cc Suffocationis. From hanging or drowning 5 counte-
nance turgid and livid.

to its degree. Upon plants a stroke of lightning of the same in-
tensity produces very different effects, in consequence of the varie-
ty they exhibit as conducting powers. Upon some it descends with-
out mischief; in others it exhausts itself on particular branches,
which are withered as though attacked by a hemiplegia. In the
betula alba^ or common birch, it never runs along the stem, but
confines its stroke to the top alone, beating off the boughs in every
direction.

Ecstasy and catalepsy seem to depend remotely upon a highly irri-
table idiosyncrasy, perhaps incidentally debilitated ; under which
circumstances the usual proximate causes, whether mental or cor-
poreal, seem to produce the one or the other disease, according as
the constitution has a greater or less tendency to entastic spasm.
Lethargy is often the result of great general exhaustion from long
continued labour, or severe and sudden exertion whether of body
or mind. It is also not infrequently produced by narcotics, or
ebriety. The author was once privy to a case of catophora that
continued for five years : the patient was a young lady, of delicate
constitution, in her eighteenth year at the time of the attack : her
mind had been previously in a state of great anxiety : the remis-
sions recurred irregularly twice or three times a week, and conti-
nued for not more than an hour or two : during these periods the
patient sighed, ate reluctantly what was offered to her, had occa-
sional egestions, and instantly relapsed into sleep. Her recovery
was sudden, for she seemed to awake a? though from a night's re-
pose by a more perfect termination of the paroxysm not followed by
a relapse. The lethargus •ui^i/, or apparent sipep, is a frequent se-
quel upon fevers, or other causes of groat debility or irritability :
in which the patient uniformly assures the practitioner and his
friends in the morning that he has passed a restless and hurried night
without a moment's sleep, while the nurse has been a witness to his
having been asleep the whole night long.

( ullen, in order to include lethargy, in all its varieties, catalepsy,
ecstacy, and asphyxy under apoplexy as a genus, is obliged to omit
the very prominent symptom of stertorous^ or sonorous breathings
which is regarded as pathognomic by almost every other nosologist :
this definition is " motus voluntarii fere omnes imminuti, cum so-
pore plus minus profundo, superstite motu cordis et arteriarum.'"
But this is to confound diseases, by simplifying without distinction.
His definition of paralysis is equally liable to objection : it is as fol-

GE. IX.] NOSOLOGY. 289

The cause is here evidently obstructed respiration.
Dr. Cullen makes this variety a species of apoplexy:
but this is to divest apoplexy of its pathognomic cha-
racter of stertorous sleep.
Khafe. Of Persian origin.

C Mephytica. From carbonic acid gass, or other irre-
spirable auras, by the miners called damps, from
the German dampff " vapour," " exhalation." In
asphyxy from this cause the countenance, instead
of being livid, is pallid.
Hur. Pcrs. Literally choke-damp, " suftbcatio ab
exhalatione putei," as explained in the Constanti-
nople edition of the Ferhcnghi Shavari, or Dictio-
nary of Literati,
y Algida. From severe cold. Limbs rigid, counte-
nance pallid and shrivelled.

lows : " motus voluntarii nonnulli tantum imminuti, scepe cum soporeP
This definition miscombines those species of palsy (if such exist,)
that are characterised by sopor or sleep, with various cases of apo-
plexy as interpreted by his own character of this last disease. So-
por however, in the sense of sleep, does not, properly speaking,
constitute an essential symptom of paralysis in any case : if it at-
tend at any time it is a mere accident ; and this is so generally un-
derstood and admitted, that some nosologists, as Sauvages and Sagar,
while they properly place apoplexy under the order of comata, re-
move palsy to a separate order, with which sleep or coma has no
necessary connexion.

Some nosologists have transferred to this division the local insen-
sibilities and atonies of the external senses or parts of them. But
as these are, in almost every instance, connected with other symp-
toms and other derangements of such organs, or their respective
functions, they rather belong to the second order of the present
class than to paralysis in the strict sense of the term : they are
wo-e* 7r«|asAyT<xe<, rather than 5r«|«At/<r«5 ; and in the system before us
are arranged accordingly.

1. Cams Asphyxia. Whatever be the cause of asphyxy, if it act
slowly and progressively, or imperfectly, the symptoms often as-
sume an apoplectic character, and the disease terminates in a para-
lytic affection more or less general. Thus stertorous breathing, a
swollen projecting tongue, and suffused and prominent eyes, are
frequently the result of imperfect suspension by the neck ; and we
have an interesting case published by Dr. Babington in the Medico-
chir. Trans, vol. i. 83, of a similar effect from breathing through
the whole of the night a diluted vapour, for so it must have been,
37

290 ISOSOLOGY. [CL. IV.-OR. IV.

J Electrica. From lightning, or severe stroke of elec-
tricity. Limbs flexible ; countenance pale ; blood
uncoagulable. In this variety the system seems to
be totally exhausted of its irritable and contractile
power.

2. EcsTASis. Total suspension of mental power and voluntary

motion ; pulsation and breathing continuing ;
muscles rigid ; body erect and inflexible.
Catochus. Linn, et Auct, Var,
Ecstasis. Sauv. Vog. Sag,
Jezbe. Arab.
Entziickung. G.
Ecstase. F.
Ec Stacy.

Said to be produced by profound contemplation or
attention of mind, or overwhelming passion. In which
case it is reverie with a spastic diathesis. Dr. Cul-
len regards it as a modification of apoplexy.

See Act. Nat. Cur. Vol. I. Obs. 250. IV. 105. VII.
40. Hist, de VAcad. Royah des Sciences. Paris, 1 738,
p. 56. Eph. Nat. Cur. passim. In one case from
suppressed menstruation ; Behrend''s Briefe iiber die
wahre Beschaffenheit ; &c. Fr, 1768.

3, Catalepsia. Total suspension of mental power, and volun-

of carbonic acid gass from burning charcoal. Of two persons ex-
posed to its action in the same room, the younger, a boy of thirteen,
died apparently during his sleep ; the elder, a man of thirty-eight,
was found, upon being called in the motning between six and seven,
in an apoplectic state, and labouring under the symptoms described
above. The application of voltaic electricity surprisingly increased
the power of the muscles of respiration, but appeared rather to
diminish the action of the heart. It was hence used alternately
with a forcible inhalation of oxygen gass, and various external
stimulants. Venesection does not seem to have been beneficial.
The man recovered in a few days.

3. Cams Catalepsia. In this species the countenance is said to
be florid, and the eyes open, and apparently fixed intently upon an
object, but without vision. It is a disease of rare occurrence, and
varies in its duration from a few hours, or even minutes, or two or
three days. It returns sometimes at stated periods. Forty grains
of tartar emetic have been given without effect. Behrends, in
Baldingen N. Magazin, Band ix. p. 199. In the case of a school
hoy, aged eleven years, the paroxysms recurred ten times in twen-
ty-four hours, and never exceeded three minutes in duration. If

CE. IX.] NOSOLOGY. 291

tary motion ; pulsation and breathing conti-
nuing ; muscles flexible ; body yielding to
and retaining any given position.
Catalepsis. Sauv, Linn, Vog. Sag, PlouqmU
Bikhudlik. Of Persian origin.
Catalepsie.
Trance.
4. Lethargus, Mental and corporeal torpitude, with deep,
quiet sleep.
Carus Lethargus. Young.
Subat. Arab.
Lethargy.

The term is applied by the Arabian physicians, not
only to the varieties enumerated below, but to comatose
affections generally. The Persian and Turkish writers
employ the same word, but more usually in connexion
with derd, or morbus ; writing it, derdus subat.
K Absolutus. Without intervals of sensation, waking,
or consciousness.
Lethargus. Sauv. Linn. Vog, Sag.
C Cataphora. With short remissions or intervals oV
imperfect waking, sensation and speech.
Cataphora. Sauv. Linn. Vog. Sag,
Coma somnolentum. Jiuct, Var.
Assoupissement. F,
Sleepiness. Somnolency.
y Vigil. Perfect lethargy of body, but imperfect le-
thargy of mind; wandering ideas, and belief of
wakefulness during sleep.
Typhomania. Auct. Grcec. Sauv. Linn. Vog.
Coma vigil. Auct. Var,
Apparent sleep.

Each of the varieties found occasionally as a
symptom in fevers of various kinds ; concussion, or

the attack commenced while walking, the same pace was main-
tained, though without the direction of the mind. Steams^ Americ.
Med. and Phil. Regist. v. I. viii. The nosologists however mention
a variety, in which the powers of deglutition and digestion continue,
the food being thrust into the mouth. It has been found to be pro-
duced by the same causes as the preceding species ; and in these
cases is perhaps reverie with a spastic diathesis. Cullen ranks this
also as a modification of apoplexy ; but, like the preceding, it is
destitute of stertorous sleep.

292 NOSOLOGY. [CL. IV.- OR. IV.

Other injuries of the brain ; and repelled gout, or
other supposed humours or exanthems.
5. Apoplexia. Mental and corporeal torpitude, with stertorous
sleep.

Aphronia, (u<p^miu.) Hippocr.

Apoplexia. Sauv, et Auct. Recentior,

Carus Apoplexia. Young,

Comus Apoplexia. Parr.

Sektet. Arab.

Schlag. G.

Apoplexie. F,

Apoplexy.

x Sanguinea. With a hard full pulse and flushed coun-
tenance.
Apoplexia sanguinea. Sennert. Sauv. Cull.
Coup de sang. F.
Sanguine Apoplexy.

? Serosa. With a feeble pulse and pale countenance.
Apoplexia serosa. Preysinger. Cull.
Apoplexia pituitosa. Sennert. Sauv.
Serous Apoplexy.

The one or other variety found also occasionally,
as a symptom, in ebriety, or other affections of the
stomach, especially from over-doses of narcotics ;
sudden gusts of passion ; repelled eruptions, or sup-
pressed humours ; in various fevers ; inflammations :
hysteria, and epilepsy.

See an interesting case of apoplexy from swallow-
ing six ounces of laudanum, cured by an active dose
of sulphat of copper given six hours after the acci-
dent, and keeping the patient in constant motion
through the ensuing night : in Dr. Marcet's communi-
cation, Medico-chirurg. Trans, i. 77.

6. Cams Paralysis, " For many years I have been particularly
attentive to those who have been attacked with a paralytic stroke,
lorming a hemiplegia. 1 have watched them while alive that I
might have an opportunity to open them when dead ; and in all I
found an injury done to the brain in consequence of the extravasa-
tion of blood. 1 have examined them at all stages ; when it was
recent, some of weeks standing, others of months, and a few of
years, in which I saw the progress of reparation." Hunter on
Blood, p. 213. He regards apoplexy as merely differing from
paralysis in degree. Under this view he strenv.ously opposes in

GE. IX.] NOSOLOGY. 293

6. Paralysis. .Corporeal torpitude, and muscular immobility
more or less general ; without somnolency.
Paralysis. Auct. Groec. et Recent.
Zemin, ^rab. Zeminlik. Turc.
Gicht. G.
Paralysie. F.
Palsy.

x. Hemiplegia. Affecting, and confined to, one side of
the body.
Hemiplegia. Auct.
C Paraplegia. Affecting, and confined to, the lower
half of the body on both sides.
Paraplegia. Auct.
y Particularis. Affecting, and confined to, particular
limbs.
Paralysis partialis. Cull. Parr.

Found also, under one of these varieties, occasional-
ly as a symptom in fevers; exanthems ; colic, and
other affections of the intestinal canal; gout, rheuma-
tism, struma, syphilis, trichoma ; diseases of the ex-
ternal organs of sense ; wounds, and other external
injuries.

both these diseases a stimulating treatment, and even objects to
blistering. " This (the stimulating treatment) is even carried
. further than blistering : we hardly see a man taken with all the
signs of an apoplexy, where a paralysis in some part takes place,
or hemiplegia, but he is immediately attacked with cordials, stimu-
lants, electricity, &.c. Upon a supposition that it is nervous, debili-
ty, &c. the poor body is also tortured because it cannot act, the
brain not being in a condition to influence the voluntary muscles ;
we might with exactly the same propriety stimulate the fingers
when their muscles were torn to pieces. I must own I never saw
one of them which had not an extravasation of blood in the brain
when opened, excepting one who died of a gouty affection in the
brain, with symptoms similar to apoplexy. Such a case, mo«t pro-
bably, would require a very different mode of treatment; therefore
when it happens to a gouty man, bUsters to the head, feet, &c.
would probably be the best practice ; but surely this would not be
the proper practice in a rupture of a vessel. We ought to bleed
at once very largely, especially from the temporal artery, till the
patient begin to show signs of recovery, and to continue it till he
might begin to become faintish. We should give saline purges
freely to diminish impetus, and promote absorption : then quietness
should be enjoined, and as little exercise of body as possible, and
especially to avoid coughing and sneezing. Plain food should be
directed, and but Httle of it.'' //««<er on Blood, p. 213

CLASS ¥•
GENETICA.

DISEASES OF THE SEXUAL FUNCTION.

ORDER I.

CENOTICA.

AFFECTING THE FLUIDS.

Morbid discharges ; or excess, deficiency, or irregularity of
such as are natural.

GENUS I.

PARAMENIA.

Morbid evacuation, or deficiency of the catamenial flux.
Mismcnstruation.

Class V. Genetica. rmnxK, from yiDiofuct, " gignor," whence
yau-K, " origo, ortus." In almost every preceding system of
nosology the diseases of this function are scattered through eyery
division of the classification, and are rather to be found by ac-
cident, an index, or the aid of the memory, than by any clear
methodical clue. Dr. Macbride's classification forms the only ex-
ception the author is acquainted with; which, however, is rather
an attempt at what may be accomplished than the accomplishment
itself He had, therefore, in a considerable degree to beat his way
through an untrodden glen, and to mark out a path for his own use.
In this view he may be thought entitled to the indulgence of the

GE. I.] NOSOLOGY. . 295

1. oBSTRucTioNis. Catamenial secretion obstructed in its

course ; sense of oppression ; languor ;
dyspepsy.
Arrhoea («gpo<(j.) Hippocr.
Amenorrhoea. Cull. Fog.

K Emansio. Obstructed on its accession or lirst ap-
pearance. Feet and ancles edematous at night ;
eyes and face in the morning; with other chloro-
tic symptoms.
Amenorrhoea emansionis. Cull.
Retention of the menses,
C Suppressio. Obstructed in its regular periods of re-
currence. Head-ache, dyspnoea, palpitation of the
heart.
Amenorrhoea suppressionis. Cull.
Suppression of the menses.

2. DiFFiciLis. Catamenia protruded with great local pain, and

especially in the loins ; part of the fluid coa-

gulable.
Menorrhagia stillatitia. Sauv.
Amenorrhoea difficilis. Cull.
Menorrhagia difficilis. Sauv.
Dysmenorrhoea. Linn. Sag.
Laborious menstruation.

medical community : yet if deficiencies or other errors exist, he has
little doubt that the general principle of the division will be ap-
proved, and its leading features be allowed currency. The ordinal
term Cenotica (xsvaTw*, from xztuirii, " evacuatio, exinanitio ;")
Orgastica (•^yao-T<*<«, from c^yed^a, " irrito, incite, and especially
libidinose ;") and carpotica {xet^TroTiKu from xǤ{ra?, " fructus,") are
sufficiently explanatory of their intention,

Ord. I. Cenotica. See the preceding note. The term is copied
from Galen, ad Glauc. lib. ii.

Gen. I. Paramenia. IIx^xix7iv;a, : from jra^a, " male," and m*,
" mensis." The genus is intended to comprise diseases that relate
to the menstrual flux or vessels exclusively. This fluid is incor-
rectly regarded as blood by Richerand aph. clxxi, and other physio-
logists : for, in truth, it has scarcely any common property with
blood except that of being a hquid of a red colour. It is chiefly
distinguished by its not being coagulable ; and, hence, when coagula
are found in it, as in laborious and profuse menstruation, serum or
blood is intermixed with it, and extruded at the same time from
atony or entonic action of the menstrual vessels. " It is neither
similar to blood taken from a vein of the same person, nor to that

296 NOSOLOGY. [CL. V.-OR. I.

3. suPERFLUA. Catamenia excessive, and accompanied with

hemorrhage from the menstrual vessels.
Excessive menstruation.
tt. Crebra. Excessive from a too frequent recurrence.

Menses antevertentes. Sennert.
C Profusa. Excessive from too large a flow at the pro-
per periods.
Menorrhagia rubra. Cull,

Catameniorum fluxus immodicus. Hippocr. Foessii.
Tarns. Arab.

Perte de sang des femmes. — Hemorrhoisse. F.
Profuse menstruation.

Issue of blood, St. Matth. ix. 20 : in the Greek origi-
nal, the person affected is termed yvvvi ^tfte^fetva-x.

4. ERRORis. Catamenia transferred to, and excreted at remote

organs.
Menorrhagia erronea. Sauv.
Mensium per aliena loca excretio. Sennert,
Vicarious menstruation.

ec, Ex oculis Aliens. Dodoncei Obs. cap. xv. Boerh. Aph.
C Ex naribus. Parcei, xxv. 12. Brassavol, Aph. xxxiii.

sect. V.
y Ex alveolo dentis. Ronssei de Horn, primord c. 28,
^ Ex auribus. Brassanol. Aph. xxv. sect. 4.
E Ex mammarum papillis. Amat. Cent. ii. cur. 21.

Parcel, lib. xxiii. c. 32. Cordcei Comm. in libr.

Hippocr. de morb. Mulier.
^ Ex vomitu. Hipp, de morb. Mul. Aretoii, lib. ii.

cap. 2.

whieh is extravasated by accident in any other part of the body;
but is a species of blood, changed, separated, or thrown oflf from
the common mass by an action of the vessels of the uterus, similar
to that of secretion ; by which action the blood loses the principle
of coagulation, and I suppose life." Hunter on Blood, p, 88. Cruik-
shank supposes it to be thrown from the mouths of the exhaling
arteries of the uterus, enlarged periodically for this purpose. Anat.
of the Absorbents. As this distinction has not been sufficiently at-
tended to cither by nosologists or physiologists, many of the dis-
eases arranged under paramenia have been placed under a genus
named menorrhagia, which, properly speaking, should import he-
morrhage, (or morbid flow of blood alone) from the menstrual ves-
sels ; and hence, we have in this instance, not only a wrong doc-
trine, but the formation of an improper genus : for menorrhagia or

OE. II.] NOSOLOGY. 297

5) Per intestina. Galen, in aph. xxxv. s. v.
6 Ex podice. Parcei, lib. xxiii. cap, 12.
< Per urinam. BrassavoL Aph. xxx. s. v.
• * Ex umbilico. Micolai Florent. Serm. ii. c. 8.
A Ex digito. Mercat. de Mulier : affect, lib. i. c. 7.
f* Ex cute. Haller. comment. 667, p. 87.

See also Cruikshank on Absorb. 4to. p. 34, Phil,
Trans. Vol. XIV. 121. i^icAerancL Elem. de Physiol,
aph. clxxi.
o. CEssATioNis. Catamenial flux irregular at the term of is
natural cessation ; occasionally accompani-
ed with symptoms of dropsy, glandular tu-
mours, or spurious pregnancy.
Has sometimes continued to a very late period of
life. To the age of 71 ; Holdefreund^ Erzahlungen, n.
4. To the age of 80; Bourgeois, Hebammenb. part. ii.
cap. 6. To the age of 90 ; Hagendorm, cent. ii. obs.
84. See for various cases Pelargus, Med. Jahr. iii. 347,
and following.

GENUS II.

LEUCORRHCEA.

Mucous discharge from the vagina, commonly without infec-
tion ; disappearing during menstruation.

uterine hemorrhage is, correctly speaking, only a species of the
genus haemorrhagia ; and will be so found in the present system.
See CI. III. ord. iv. This remark applies directly to Sauvages ; and
more peculiarly so to Cullen, who, for the sake of simplifying, has
carried the confusion still further. Few diseases perhaps of the
uterus or uterine passage can be more distinct from each other than
vicarious menstruation, difficult or laborious menstruation, lochial
discharge, and sanious ichor ; yet all these, with several others
equally exceptionable, are arranged by Sauvages under the genus
monorrhagia, though not one of them belongs to it. While Cullen
not only copies nearly the whole of these with the names Sauvages
has assigned them, but adds to the generic list leucorrhoea, or
whites ; abortion ; and the mucous fluid secreted in the beginning of
labour from the glandulse Nabothi at the orifice of the womb, and
hence vulgarly denominated its show or appearance.
:^f3

^

298 NOSOLOGY. [CL. V.-OR. I.

Leucorrhoea. Sauv. Linn. Vog. Sag. Plouq,

Menorrhagia alba. Cull,

Fluor albus. AucU Var.

Weisse flusse. G.

Fleurs blanches. F.

Whites.

1. COMMUNIS. The discharge of a yellowish-white colour, verg-

ing to green.
Has been found occasionally contagious. Act. Med.
Berol. Dec. I. vol. v. p. 85. In Sweden endemic, Ried-
lin. Lin. Med. 1695, p. 164.

2. Nabothi. Slimy, and for the most part tinged with blood.

Secreted by the glandulae Nabothi situate on the
mouth of the uterus ; and chiefly on the beginning of
labour.

Leucorrhoea Nabothi, Sauv.
Hemorrhagia Nabothi. Cull.
Labour-show.

3. sENESCENTiuM. Thin, acrid, frequently excoriating and fetid.

Secreted on the cessation of menstruation ; often
chronic and obstinate.

Found also, occasionally, as a symptom in cases
of a scirrhous or pro'apsed uterus.

GENUS III.

BLENORRH(EA.

Muculent discharge from the urethra, or vagina : general-
ly with local irritation, and dysury : not disappear-
ing during menstruation.

Gen. II. Leucorrh(Ea. AtvKop^otct : from Aiv»e;, " white," and '^m,
" to flow." The term is comparatively of modern origin, occur-
ring in neither the Greek nor Roman writers ; and appears first to
have been met with in Bonet, or Castellus.

Gen. III. BLKNORRHoeA. From Zxttm^ '• mucus," and ^e0, " fluo."
Sauvages, and after him Cullen, have employed Gonorrhcea, from
yonof, semen, and f^ut. as a common term for this and the ensuing
genus ; and hence morbid secretion of mucus, venereal contagion,
and aeminal flux are all arranged as species of the same generic

o

GE. III. j NOSOLOGY. 299

PhallorrhcEa. Plouquet.
Gonorrhoea. Sauv. Cull.
Catarrhus gonorrhoea. Parr.
Blenorrhoea urethralis. Young.

1. SIMPLEX. Simple " increased secretion from the mucous

glands of the urethra." Fordyce.
Gonorrhoea pura. Sauv. Cull.
Gonorrhoea benigna. Auct. Var.

2. LUODES. Muculent discharge from the urethra or vagina in-

termixed with specific venom ; burning pain in
micturition : produced by impure coition : in-
fectious.

Gonorrhoea impura. Cull.

Gonorrhoea syphilitica. Sauv.

Gonorrhoea virulenta. G. maligna. Auct. Var.

Abserdi. Arab.

Kalte-biss. G.

Chaudpisse. F.

Clap.

3. CHRONICA. Slimy discharge from the mucous glands of the

urethra; without specific venom or infection :
slightly irritating ; chronic.
Gonorrhoea mucosa. Cull.
Gleet.

Mostly a sequel of the preceding ; and usually accom-
panied with stricture or enlarged prostate gland.
Though, without specific venom, occasionally so acri-"
monious, as to produce great local inflammation on the
person cohabited with, while the secreting organ which
has undergone the morbid change, is torpid, or nearly
so, to its virulence.

disease : and this, too, under a word which imports the last alone.
While, to add to the confusion, this very word, in its vulg'ar use,"
is restrained to venereal contagion, which it signifies just as much
as it does abortion or stone in the bladder. It is his^h time to make
a distinction ; and to divide the list of Sauvages into two gf^iera.
Blenorrhoea, indeed, has already been employed of late by various
writers to denote the first of these genera, and there is no necessi-
ty for changing the term. Gonorrhoea would answer equally well
for the second, were it not for the general though absurd applica-
tion of the word to venereal virus, which has induced the author
to make a change.

300 NOSOLOGY. [CL. V.-OR. I.

GENUS IV.

SPERMORRHCEA.

Involuntary emission of seminal fluid witiiout copulation.
Gonorrhoea. Linn. Sag.
Vedaf. Arab.
Saamenfluss. G.

Effluxus perpetuus per foramina praeternaturalia ab-
dominis. Eph. J^at, Cur. Dec. I. ann. ii. obs. 185.

See Wichman, De Pol. diurn, Goeit. 1782. Some-
times intermixed Avith blood. Pelars^us, Med. Jahrg. iii.
769.

1. ANTONicA. Involuntary emission of a dilute and nearly pel-

lucid seminal fluid ; with libidinous propensi-
ty ; but without erection.

Gonorrhoea libidinosa. Sauv,

Gonorrhoea laxorum. Cull.

2. ENTONicA. Involuntary emission of proper semen with

Gen. IV. Spermorrhcea. From o-flri/p**, "sero," "semino :" whence
«<77regf4o?, " semine carens^''^ yvf,cvoa':ri^^oi, " cujus semen nudum esi," a
weli-knowa term in botany ; and hence also numerous other deriva-
tives of the same kind. Gonorrhoea would have been retained in
the sense intended by this genus, but from the confused signification
in which, as already observed, it has been employed by Sauvages
and CuUen ; and from its being usually, though most improperly,
applied in the present day to blenorrhcea luodes.

Of the first species here enumerated, spermorrhoea atonica, Sauv-
ages gives two examples : the former from Deidier, in which the
patient was an exemplary monk, who shrunk with horror at the
idea of this involuntary self-pollution, as he regarded it: the latter,
a case in his own practice, in which the patient, a most religious
young female, was, as he affirms, driven almost to madness under
the same erroneous contemplation of the disease. From this last
case it should appear that Sauvages inclined fo the theory of epige-
nesis, or that which supposes the male and female to contribute
equally a seminal fluid in the act of procreation, it is probable
that some local irritation is the usual cause. Professor Deidier
himself suspected this in the first of the above cases ; and referred
it rather to a calculus in the bladder, sympathetically affecting the
prostate gland, than to any idiopathic disease of the vesiculae semi-
nales. 'I he pious monk found himself most relieved by scourging

GE. v.] ' NOSOLOGY. 301

erection ; mostly from indulgence of libidi-
nous ideas.
Nearly connected with paroniria salax.

GENUS V.

GALACTIA.

Morbid flow or deficiency of milk.
Sparganosis. Dioscor,
Galactia. Linn. Vog.

1. Anticipans. Efflux of milk during pregnancy.

Galactirrhoea mammarum. Sauv. Sag.
Epiphora lactea. Young.

A pint and half has sometimes been poured forth
daily as early as the fifth month. Sauv. ii. p. 412.
See also Timceus Cas. p. 220.

2. iMPOTENS. Inability to suckle upon child-birth.

« Atonica. From want of secretion.

Aglactatio. Lin7i. Sag.

Agalaxis. Vog.

Agalactia idiopathica. A. Young.
C Organica. From imperfect nipple, or other organic
defect.

3. DEPRAVATA. Efflux of a dilute or vitiated milk.

« Serosa. Weakened by too large a proportion of se-
rum.
Galactirrhoea serosa. Sauv.
C Complicata. Deteriorated by intermixture with some
foreign material.

See Ephejnr. JVo/. Curios, in which we have exam-
ples of a flow of black, green, and yellow milk. See

his legs ; a blister in the perinaeura would probably have reUeved
him still more effectually.

Gen. V. Galactia. r«A«xT<« : from yecXxy " lac," yxXxKTi»»i,
" lacteus." The author has preferred the term employee] by Linne-
us and Vogel, to galactirrhoea as used by Sauvages and Sugar ; since
the former is comprehensive enough to include deficiency as well
as excess ; both which are equally entitled to be comprised under
one common head as excess and deficiencv of arterial action in fe-

302 NOSOLOGY. [CL. V.-OR. 1.

also Saui>. ii. 412. Probably in most instances dis-
coloured by an union with effused blood.

Occasionally the quality betrays its source. Of
the nature of beer. Eph. J^at. Cur. Dec. I. ann. iv.
V. obs. 15. Vinous. Id. ann. iv. obs. 75. Cent. 1. II.
Appx. p. 194.

Violent passion has a peculiar influence in chang-
ing its natural character; especially rage, and terror.
4. ERRORis. Transferred to, and discharged, or accumulated
at, remote organs, often under a different form.
Galactirrhoea erronea. Sauv,
Agalactia idiopathica. B. Young.
« Transferred to the fauces ; and discharged in the
form of a ptyalism.

Lactis effluxus ptyalismi forma. Puzos. Ephem.
Jsiat. Curios.
C Discharged from the general surface of the mamma^

in the form of sweat. Id.
y Discharged from the navel. Id. Sauv.
S Discharged from the kidneys in the form of urine.

Journ. de Med. 1 758.
f Discharged from the eyes in the form of a milky epi-
phora. Sauv.
^ Discharged from the thigh on scarification. Id.

Weikard, Verm. schr. i. 47.
n Discharged from the veins on bleeding. Sauv.
* Discharged from the vagina. Bourdon^ Journ. des
S^avans, 1684. Paulllni, Obs. cent. i. p. 27.
Like the menstrual flux there is scarcely an organ
to which it has not been transferred. See Plouquet,
art. Menstrua.

The blood during the time of suckling is often
loaded with milk, and evinces a milky appearance ;
as are also several of the fluids secreted from the

ver. Hitherto, however, these affections have been separated from
each other by nosoloffi^ts. anH cairiefl to Hiffereni beads, somet.mes
to different orders, and ocfa«iona!ly to d.fferent classes; whence the
student has bad to hunt for them thnmpb every section of the no-
sological arrangement. It has already been necessary to make the
same remark respecting many of the speoes of paramenia; and va-
rious other instances will readily occur to the reader in the ensuing
orders.

GE. I.] NOSOLOGY. 303

blood ; and hence probably many of the above pe-
culiarities.
5. vir6rum. Secreted in males, and discharged from the pro-
per emunctory.
Galactirrhoea virorutn. Sauv.

See Colleclio Acad. HI. p. 63. A milky serum often
distils from the nipples of new-born babes of both
sexes : but various authors, as Scholtz, P. Borelli, Lau-
remberg, have given cases of genuine milk discharged
in like manner by adult males ; occasionally continuing*
for a long time ; and in some instances enabling them
to perform the office of nurses.

O R D E H II.

ORGASTICA.

AFFECTING THE ORGASM.

Organic or constitutional infirmity, disordering the power, or
the desire of procreating.

GENUS I.

CHLOROSIS.

Pale, lurid complexion ; languor ; listlessness ; depraved
appetite and digestion ; mismenstruation.

Order II. Orgastica. 0^y»i7TtK» from t^yttu " appeto impatien-
ter; propria de animantibus dicitur, quae (urgent libidine." Scapul
Orgasmus is hence used for salacity in general ; but by Linneus in a
very different sense, being restrained to snbsu tus arteriarum.

Gen. I. Chlorosis. From x^m, or ;c^«j), '' herba virens ;" whence
among the Greeks x>^u^tcfffc» and x.^a^'»<r'?i " viror," " pallor." The
most common cause of this disease is menostation or retention of
the menstrual flux. In the definition of Dr. Cullen, as originally

'^04 NOSOLOGY. [CL. V.-OR. II.

Chlorasma (xpi^jao-fta.) Hippocr. Epidero. vi.
Febris alba. Mercat. Reed, a Castro. Sennert.
Chlorosis. Sauv. et Auct. Recentior.
Dyspepsia Chlorosis, Young.
Ane;yithjmia Chlorosis. Parr.

Semna, of Persian origin 5 for semensa, (Arab.), is lite-
rally " puella albido colore languescens." From
" lilium," " jasninum." It is often applied to eroto-
mania ; and hence means also amasia.
Chlorose. F.
Greeji-sickness.
1. PLETHORicA. Habit plethoric; pain in the head, back or
loins; frequent palpitations at the heart;
flushes in the face ; pulse full, tense, and
frequent.
Chlorosis virginea. Sauv. Cidl.

The orientalists, and especially the Persians, make a
male variety of this species, which they call " bimariy
kodek," or morbus puerorum, and is designed to include

drawn up, this symptom was thus expressed conditionally, " men-
struorum scepe retentio :" in his later editions, however, he omitted
the qualification of scepe, adding " nullam, chlorosis speciem veram,
praeter illam quae retentionem, menstruorum comitatur, agnoscere
vellem." Yet in this case he should not only have omitted the
term scepe, but the genus altogether ; for, by such opinion he re~
duces it to a mere symptom of obstructed menstruation, paramenia
obstructionis ; and such, indeed, he acknowledges it to be, notwith-
standing that he continues it as a distinct genus : " fateri cogor,"
says he, " chlorosin ideo hie minus recte pro genere recensitam esse,
cum pro symptomate amenorrhceae semper haberi posset." Few,
however, have followed Cnllen in this opinion. Sauvages asserts
that there are daily cases of chlorosis with pica, or depraved appe-
tite and digestion among children in their cradles ; and Bonetus af-
firms the same of adult males. 'I'hese were possibly cases of dys-
pepsy, or simple pica in dysthetic or cachetic habits : but the wri-
ter of these pages cannot avoid concurring with those authors who
contend that it is by no means uncommon among females who have
no interruption of the menstrual flux ; though a derangement of some
kind or other in its quantity, quality, or constituent principles ap-
pears to be always connected with it, and is, for the most part, the
cause or leading symptom : and, in the generic character, the author
has hence used the term mismcnstruation (paramenia,) in preference to
amenorrhoea, or obstructed menstruation.

Dr. Young has made chlorosis a mere species of dyspepsia in his
classification : but he is not quite satisfied with this position : " 1

GE. n.]

NOSOLOGY. 305

the aftections which often peculiarly, mark ihe stage of

puberty.
2. iNOPS. Habit debilitated ; great inactivity and love of in-
dulgence ; dyspnoea on moving ; lower limbs
cold and edematous, especially at night ; pulse
quick and feeble.

Chlorosis a menstruatione difficili. Astruc.

Chlorosis a nicnorrhagia. Saxrc.

Found also occasionally, as a symptom, in preg?'ancy\,

profuse menstruation, various dysthetic diseases, and

immedicable love.

GENUS 11.
PROEOTIA,

Premature development of sexual organization, or power.

have followed (says he) a prevalent opinion, but there are various
reasons for thinking it is quite as naturally connected with amenor-
rhcea." Med. Lit. p. 282.

One species only has hitherto been allowed by most writers. Yet
the symptoms and mode of treatment of the disease, as it appears
in a vigorous, florid, and full-bosomed country girl, produced by
catching cold in the ^eei at the catamenial period or approach :
and in a delicate, pale-faced, emaciated town-girl, debilitated by an
indulgence in a course of luxurious indolence from her infancy,
seem to justify and even demand a distinction. In the former case
there is an evident redundancy of blood with powerful local spasm :
and copious venesection is loudly called for and must be beneficial.

In the other there may possibly be deficiency of blood, and no
spasm whatever, and copious venesection would only add to the evil.
The disease, in this case, is probably produced by a chemical im-
perfection or immaturity in the blood itself, so as not to keep pace
with the growth and irritability of the menstrual vessels ; and con-
sequently so as not to afford them the proper pabulum for secretion.
Here, therefore, in the first instance, it behoves us to employ a
strengthening and tonic plan, and to extend it through all the de-
partments of diet, exercise, and medicine. There can be no doubt,
however, that even the first species, if neglected or obstinate, and
of long continuance, may, and often does, by debilitating the consti-
tution, terminate in the second.

Gen. II. Pr(e6tia. U^aitrvif, or Tr^eforni-, '' prajcox maturitas,"
Theoph. de Caus. pi. from 5rg<w«, '' premature." The term is pecu-
' '^9

306 NOSOLOGY. [CL. V.-OR. U-

1. MAscuLiNA. Development of sexual precocity in males.

Bolset^ Journ. des S^avans, 1688 — Boy of
three jears old. Leske Aus. Abhandl. Band.
11. p. 354 — Various cases, and particularly that
of Philip Ha worth in his second year. Medico^
chir. Trans. 1. 276.

■2. FEMiNfNA. Development of sexual precocity in females.

Menstruation in infancy common. See Plou-
qua — Pregnancy at nine years of age, Ephenu
Nat. Cur. Dec. III. ann. ii. obs. 172 — See a se-
# cond case at the same age. ScJimid. Act. HelveU

IV. 167 : and again, in Germany, G. K. von Hal-
ler^ in Blumenbach Bibl. I. 568 — See also Eccy-
esis ovarla^ Ord. III. Gen. II. of the present class.
Dr. Baillie's case. — Two cases are given in the
Medico-chir. Trans. Vol. II. 1 1 5, by Dr. Wall ;
and Vol. IV. 204, by Mr. Astlcy Cooper.

See, for other instances, Halhr^ Elem. Phys.
Lib. XXVIII. sect. iii. Kundman. ^d^r. Art. and
Nat. p. 823.

liarly applied to premature semination. It is not necessary to dwell
further upon instances or varieties of this morbid affection, as they
may be- traced through the two species, into vvhich the genus natu-
rally divides itself, in the writings of physiologists who have been
curious upon the subject. Those who are desirous of doing so may
turn to the accounts of Bozet in the Journal des S9avans or to the
Philosophical Transactions, Vol. XLllI, year 1745. It is but a
few years ago that as striking an example ol sexual precocity, as i&
to be found perhaps any where, was publicly advertised in this me-
tropolis to be exhibited in the person of Philip Haworth, the boy
whose case is referred to in the text. In a parallel case recorded
in the Philos. Trans, the boy was nearly of the same age, being
not more than two years and eleven months old.

Gen. III. Lagnesis. Aayn*)?, '' libidinosus," " praeceps in vene-
rem." This is intended to include the satyriasis and nymphomania
of Sauvages, and later authors, which chiefly, if not entirely, dif-
fer from each other only as appertaining to the male or female
sex : and consequently by no means offer ground for two distinct ge-
nera. The disease is unquestionably one Tiu<^ the same ; the diversity
of symptoms depending upon the diversity oi sex alone. The second
species, lagnesis Furor, from its violence and affecting the entire
system, makes an approach towards a mental malady ; and hence
Vogel has regarded satyriasis and nymphomania as species of mania.

GE. III.] NOSOLOGY. 307

UENUS 111

LAGNESIS.

inordinate desire of sexual commerce, with organic tiirges-
cence and erection.

Nymphomania. Sauv. el Auct. Recent.

Satiriasis. Sauv. et Auct. Recent.

Shebek. Arab.
1. Salacitas. Appetency capable of restraint; excitation chief-
ly confined to the sexual system.

Satiriasis juvenilis. Cull.

Salacitas. Plouquet.

Nymphomania salacitas. Sennert. Sauv.

Nauz. Arab.

Geilheit. G.

Lascivite. F,

Salacity.

m Pubertatis. Of puberty. Excess of stimulus produc-
ed by the season of adolescence.

C Senilium. Of old age. From local irritation ; pro-
duced by debility, or topical malady; as diseased
ovaries ; calculus in the bladder or kidneys ; leu-
corrhoea ; or inflammation of the womb, or neck of
the bladder.

But this is incorrect : the aflfection of the mind is merely symptom-
atic. Parr, on the contrary, has ranked under lagnesis, love sickness,
a variety of erotomania or empatliema desiderii, which, in the pre-
sent and most systems, is regarded as chiefly a mental malady : but
Parr's arrangement is equally incorrect. In afi'ections however,
consisting of symptoms derived from diflerent functions, it is not
always easy to lay down their proper position. But we meet Avith
like difficulties in classing vegetables, animals, and miner.ils. The
judgment must equally direct us in all these cases, as far as it will

In the Ananitates Academics, Vol. VI. art. 110. coff'ee is recom-
mended by Dr. Sparscbuch as an excellent anti-aphrodisiac ; whotas-
serts, that it is very generally allowed in his quarter of the world
to possess a powerful virtue of this kind. He supports Ms opinion
further by a pleasant tale from the Travels of Olearius.

1. C. Salacitas Senilium. See a singular case by Mr. Norris in
the Transactions of the Medical Society. Vo]. I. p. 174, produced by

;308 -\OSOLOGY. [CL. V.-OR. II.

y Plethovica. From plethora or entonic action ; espe-
cially in a sanguine temperament.
J Ab assuetudine. From habit or immoderate indul-
gence.

The collectors of medical curiosities give various
cases of divorce obtained against a husband on ac-
count of ungovernable salacity. See Eph. J^at. Cur.
Dec. II. ann. ii. obs. i2\— Plater, Obs. t ib. I. p. 257 —
Riedlin. Lin. Med. 1697 — p. 812 — Timceus, cas. 52.
2. Furor. Appetency unbridled, and breaking the bounds of
modest demeanour and conversation ; morbid agi-
tation of body and mind.
Avekeb. jJrab.
.Lascivious madness.
« Masculinus. In males.
Satiriasis fnrens. Cull.

Pollutioiies centum per diem. Bartholin. Epist. III.
p. 145.
C F'gemininus. In females.
Nymphomania furibunda. Sauv.
Furor uterinus. ./luct. Var.

Vetulae, i?ief^/m, Lin. Med. 1697. p. 812. Often
produced by local irritation, as ascarides or infiamma-
tioi). In one instance organically, by an enormous

a blow received a few months before near the prostate gland, fol-
lowed by a small, but nearly indolent tumour on the part affected-
The patient was a married man of sixty-seven, and during the vio-
lence of the erethismus, from local irritation, which had continued
for two months, was reduced to a state of the most wretched and
squahd emaciation. The following are Mr. Norris's words :
" Nunquam memini, inquit a?grotus, me in venerem propensiorem
fuisse, nedum insana et insatiabili libidine permotnm, ante hos duos
menses, quando me diro hoc et teterrimo correptum esse morbo
sensi ; ciijiis vis tanta est et tarn effraenata, ut expleri nequeat; et
ad coitum cum uxore me singula node, quindeciessaltem, imo vicies
nonnunquam, impellat. Hie vero cum aegrotantem meum priapismo
laborantem se fallere augurabar, et fortasse, nulla seminis jactura
in venerem ruere, paulo curiosius id ab illo quaesivi. Affirmat au-
tern se vix in lecto decumbentem corpus uxons contingere, cum tan-
quam tt^stro percilus, in repetilam venerem properat, neque unquam
nisi pleno coitu res peragitur : seminis quidem cmissio potius ange-
re quam voluptatis afficere visa est." The wife, a matronly wo-
man of great modesty, was herself hereby rendered extremely ill
from local inflammation. By supporting the system with tonics,

GE. rV.J NOSOLOGl. 309

clitoris, Biichner, Miscell. 1725, p» 933. In this last
we have an approach to the female priapism o(
Galen. See Class IV. Ord. III. Gen. 1. 1.

GENUS IV.
AGENESIA.

Inability to beget offspring.
Agenesia. Vog.
Anaphrodisia. Sauv. Sag. Cull.
Sterilite male. F.

and bringing the tumour to suppuration, the disease was effectually
cured.

Gen. IV. 'Aymcrtx, from » neg. and ymftxi^ " to beget." Of the
three species offered under this genus, the division of which is en-
tirely new, the last, agenesia incongrua, is now first attempted from
personal observations of the author, in full accordance with the
remarks of other writers and practitioners upon the same subject.
Every one must have noticed occasional instances in which a hus-
band and wife, apparently in sound health and the vigour of age,
have no increase while together; either of whom neverthelciss,
upon the death of the other, and a second marriage, becomes the
father or mother of a numerous family. In various instances, in-
deed, the latent cause of sterility, whatever it consist in, seems gra-
dually to diminish, and the pair that for years was childless, at
length becomes enriched with offspring. In all this there seems to
be an incongruity, inaccordancy, or want of adaptation in the con-
stituent principles of the seminal fluid of the male to the sexual
organization of the respective female ; or, upon the hypothesis of
the epigenesis, to the seminal fltiid contributed by the female. Wri-
ters, strictly medical, have not often adverted to this subject, though
it is appealed to, and, for the most part, approved by physiologists
of all ages and countries. Sauvages however evidenily alludes to
and admits such a cause in his definition of dysspermatismus serosus,
which is as follows : " Ejaculatio seminis aquosioris^ adeoque ad gene-
sim inepti, quae species est frequentissimuni sterilitotis virilis princi-
pium/- He illustrates his definition by a case which occurred to
Haguenot and Chaptal, who attributed it to the cause in question,
and refers for other examples to Etmuller. Cullen expresses him-
self doubtfully upon this species: " De dysspermatismo seroso
Sauvagesii." says he. " mihi non satis constat/"' Yet his own go-

310 NOSOLOGY. [^. V.-OR. II.

Male SteriBty.
1. Impotentia. Imperfection or abolition of generative power.
Seres. Arab,

norrhcea /axormn, Gen. CXXII. (in the present system spermorrhoea
atonica) makes so near an approach to it, that a transition from this
to the preceding genus seems difficult to be avoided. The two dis-
eases appear to be the same, or nearly so : in the one, the individu-
al, labouring under it, emits involuntarily, without coition, or even
erection, but with a libidinous propensity, a pellucid fluid apparent-
ly of a seminal character, affirmed positively by Sauvages, from
whom Cullen derives his species, and to whom he refers, to be
" effluxus seminis ;" and in the other the same dilute and effete se-
men, with difficult and imperfect erection, is poured forth during
coition.

The opinion, however, expressed in the species before us, offers
a more compr^ hensive view of the subject; by supposing that the
seminal fluid may be secreted, not merely in a state of morbid di-
luteness, but under various modifications, even in a state of health,
of such a condition as to render it inadequate to the purposes of ge-
neration in female idiosyncrasies of some kinds, while it may be
perfectly adequate in those of other kinds. In agricultural lan-
guage it supposes that the respective seed may not be adapted to
the respective soil, however sound in itself. In Dr. Parr's diction-
ary, article Anaphrodisia, we meet with an approach to this view;
for he tells us, that '' in some instances the semen itself seems de-
fective in its essential qualities."

Among physiologists, the doctrine here thrown forth has been
very generally held. It necessarily follows upon the hypotheses of
Maupertuis (Fenws Physique,) Needham [Phil, Trans. Vol. XIV.)
Buffon, and Lieberkuhn. Linneus embraced it from the latter,
abandoning, for this purpose, the hypothesis of Leuwenhoek. Koel-
reuter has applied it, with much satisfaction, to the sexual system
of plants ; and has been followed by Werner ; both of whom have
endeavoured to show, that formative molecules exist equally in the
generative organs of male and female, and that hybrids are hence
alone capable of production. They have apparently detected
means of modifying the generative or conceptive power by culture ;
and both the Hiibers have successfully applied the same process to
the bee ; distinctly proving, that by means of particular foods and
regimen alone, they are capable of making a difference not only in
the bulk, instinct, taste, habit, and procreative power, but even in
the sex itself of (jg^ insect, as it is vulgarly contemplated, and ex-
.plained by the na3|) of neuters.

The writer has saul that a similar opinion has been held in all
couotrios. It may be sufficient, in the present note, to point out an

€

(JE. IV.] ^ NOSOLOGY, 311

Schwachmiithigkeit. G.

Impuissance virile. F,

Male Impotence,

M. Atonica. From imbecility, or want of tone.

Chiefly produced by excess of indulgence ; long-
continued gleet ; or paralytic affection of the genera-
live organs.

example or two. In Abdollatif's History of Egypt, written at the
close of the twelfth century, the historian, in observing that the
Egyptian mules are the largest whose dam is a mare, offers this
reason, "mater enim est quae dat materiam." See Dr. \^ bite's
Ahdol. Hist. Egypt. Compead. Arab, et Lat The learned Arabian,
it seems, was of the same hypothesis as Swammerdam and Harvey.
The whole of the doctrine, however, which is here alluded to, the
entire theory, ind«ed, of epigenesis in all its ramifications and rea-
sonings, formed a part of the Epicurean philosophy, and is so fully
unfolded by Lucretius in his fourth book, De Rer. JYat., that later
physiologists who have embraced the same principles have had no-
thing more to do than to confirm its doctrines by additional facts and
observations, and to verify the following axiom which forms the pivot
of the entire machinery, v. 1222:

Semper enim partus duplici de semine constat.

For a pretty full survey of most of the theories of generation
maintained in early eras, compared with those of modern times, the
reader is referred to the present writer's notes on his translation of
the above book of Lucretius, especially that on v. 1264 of the
translation. He may also consult with advantage Wildenow'^s " Prin-
ciples of Botany," § 292, and especially the " Generatio Ambige-
na" of Dr. Ramstrbom, in Vol. VI. of the Amomiitates Academicce.'^'

The species here denominated impotentia is perhaps more gene-
rally called by the nosologists anaphrodisia, though this last term has
been used in very different senses ; sometimes importmg want of ap-
petency ; sometimes inability ; sometimes both ; and sometimes only
a particular kind of inability resulting from atony alone. The dyssper-
matismus of authors is changed, in the present nomenclature, to dyss-
permia (^^vra■7n^ft^tt,) not only on account of greater simplicity, but in
conformity with the parallel Greek compounds ■/ruvrTrt^unt, w»A«<rwigM.««,
yvfittTnt^fAnc^ ttTTTt^fcix; the second and third of which are elegantly
introduced into the Linnean vocabulary of botany, {jpolyspermous
capsule and gymnospermous seed,) and are in the mouth of every
one. Dysspermatismus is usually spelt dy-sperm^tismus ; and thus
made to import double-semination rather than mi^^mination ; as dy-
oides (St;<M^jj5) means " a double form,'' and dt^mmus {'^vua-f.cei,) " a'
double opinien, or doubt."

With respect to these two species, so closely connected hyj^a-
ture, there is perhaps no artificial system of nosology under 'ij^ch

312 NOSOLOGY. [CL. V.-OR. II.

C Organica. From morbid organization, natural or
accidental ; as amputated, injured, or enormous
penis; testes impaired or destitute.

Albinus gives a case of divorce obtained against
a husband from inability to enter the vagina, oh
penum enonnem. Dissert, de Inspectione corporis,
forensis, in causis matrimonialibus fallacibus et
dubiis. Hall. 1740. — Plater relates another from
a similar cause, Obs. Lib. I. p. 250.
2. Dysspermia. Imperfect emission of the seminal fluid.
Dyspermatismus. Sauv. Cull.
Inepuissance d'ejaculation. F.
1 Etohica, From super-erection or priapism,

Dyspermatismus hypertonicus. Sauv. Cull. See also
Edin. Ess. I. 35. Cockhurn Edinb. Essays, I. 35.
A case has lately occurred to the author.
C Epileptica. From incursion of an epileptic spasm
produced by sexual excitement during the inter-
course.
Dyspermatismus epilepticus. Sauv. Cull.
y Anticipans. The discharge ejected hastily, prema-
turely, and without due adjustment.
Schenck, Observ. Lib. IV. Obs. 46.
S Ignavis. The discharge unduly retarded from hebe-
tude of the genital organs.
Dyspermatismus apractodes. Sauv. Cull.
Bradyspermatismus. Anct» Var.

they have hitherto been introduced into the same subdivision. In
almost every instance they have been regarded as distinct genera be-
longing to distant orders or even classes, and arranged with diseases
that have little or no relation to them. Thus'in Sauvages, anaphro-
disia, in the sense of impotentia, occurs in his Class VI. Ord. II.
" DEBILITATES, ANEPi rHVMiiE," United vvith " loss of thirst," and " de-
sire of eating:" while dysspermatismus is carried forward to Class
IX. Ord. III. " FLUxus, SEKiFLUxus." — Cullen has felt it necessary
to deviate in both cases of arrangement from Sauvages, whom he
follows almost wherever it is possible, vvith a deference and modesty
worthy of all praise ; and has removed the two into one class, the
common aggregate tiivision of locales, but has placed them under
dififerent orders ; the first being arranged under Ord. II. dysorexi^e,
where we again find the morbid cravings of the alimentary canal
united with those of the sexual organs, and even of the mind, as
in the genus nostalgia ; the second being [»laced under Ord. V^
EPiscHESES, "suppressions," instead of "fluxes." as in Sauvages

GE. v.] . NOSOLOGY. 313

s Reliuens. The discharge thrown back into the vesi-
culae seminales or the bladder, before it reaches
the extremity of the penis.
Dyspermatismus refluus. Sauv. Cull.

Semen retrogradum in vesicam ex angustatione
urethrffi, Petit., Memoires de TAcademie de Chirurgie,
I. p. 434.
^ Organica. The discharge obstructed by mechanical
pressure; as that of stricture or hardened mucus
in the urethra ; indurations in the corpora caverno-
sa ; or a prepuce nearly imperforate.
Dyspermatismus urethralis ; niucosus : nodosus ; praj-
putialis. Sauv. Cull.
3. INCONGRUA. The seminal fluid inaccordant, in its constituent
principles, with the constitutional demand of
the respective female.
Dyspermatismus serosus. Sauv.

GENUS V.
APHORIA.

Inability to conceive offspring.
Sterilitas. Linn. Sag.
Asthenia aphrodisiaca. B. Aphoria. Young.

In Parr, dysspermatismus does not appear to have any place : he
may possibly have regarded it as a variety of his agenesia, employ-
ed as a species, and limited apparently to impotentia ; but with this
limitation it would scarcely follow as a proper variety.

Among plants we sometimes meet with an equal want of power :
occasionally from imperfectly formed styles or stigmas, stamens or
anthers ; sometimes from suppression of farina ; and sometimes
from a total destitution of seeds: which last defect is common to
bromelia Ananas ; musa paradisiaca, or Banyan ; artocarpus incisa^
or bread-fruit-tree ; and berberis valgaris. or common berberry.

Gen. V. Afhoria. A(pag««6, " sterilitas ;" " infecunditas," from
(p6g», " fero," " porto." Pl&t. Pint. It is singular that this disease
finds no distinct place in any of our most esteemed nosologists. It
may possibly be intended under anaphrodisia, though this genus has
in none of them any species that expresslv applies to female bar-
40

■•'•I ^

311 NOSOLOGY. [CL. V,-OR. H.

Aiccnia. Cricht^-
Akret. Jrah.
Unfruchtbarkeit. G.
Sterilile des femmes. F.
Female sUrilily. Barrenness*
l.fMPOTSNs. Imperfection or abolition of conceptive power.
M, Atonica. From imbecility or want of tone, as in the

preceding genus, sp. 1. «. Atechnia atonica,
* Organica. From organic defect, whether natural or

accidental, as imperforate vagina, defective fimbriae,

or ovaria ; wAnt of ova, &c.

Atecnia organica. Crichu

An imperforate vagina does not always preclude

conception. — It has taken place where the vagina

itself has been so narrow' as not to admit the penis.

Ephem. Xat. Cur. Dec. III. ann. vii. viii. obs. 83

— Where, with the same impediment, a rigid and

unbroken hymen has offered an additional obstacle.

Hist, de Pjicad. de Paris, 1748. And for similar or

nearly similar circumstances, see Forest, xxxix.

obs. 29. Schurig. Syllepsil. p. 131. Akakia, Lib.

I. cap. xi.
'2. PARAMENicA. Barrcnncss from mismenstruation.

«6 Obstruclionis. Produced by menostation or retention

of the catamcnia.
C Difficilis. Produced by laborious secretion.

r^nness. Dr. Young has properly placed impotence, dysspermatis-
mus, and barrenness, together. His genus is asthenia, and they oc-
cur, as subdivisions, under the species ap/jrorfmaca. For barrenness
he employs the term aphoria, made use of in the present system.
Crichton, who makes it also a distinct genus, employs atecnia as its
generic name (arejtwa,) a word, however, that should rather import
destitution or bereavement than barrenness — " orbitas, prole carens."
Arist. Polit. ii. ; and which, independently of this, is calculated to
prodiice some confusion, as Linneus has used it in the sense of" des-
titution or deficiency of appetence" — libidinis defectus, gen. cxix.
By Cullen and Parr, this word is spelt atechnia ; and by the last de-
rived from u neg. and ti^.'^ai ^'^■^'- The derivation, so far as relates
to atechnia {<trix.n»,) is correct ; yet it is a misapplication of its
meaning to apply atechnia to sterility, for its constant import,
whether employed literally or figuratively, is " unskilfulness, rude-
ntjhs^ ui, destitution of art" — imperitia. But it is, perhaps, impossi-
ble t6S]ft»rni6h an example of its denoting rudeness or unskilfulness,
much le?i*"yV*jpt of physical power, iu the fabrication of offspring.

<Tf:. VI. J ■■ NOSOLOGY. 3U)

y Superrtuitatis. Produced by profuse discharge.

3. iMPERciTA. Barrenness from personal aversion or want of

appetency: cestro impercita. So Lucr. i. 12.
conversely :

" te, Diva, tuumque

Significant inituni, perculsa^ corda tu;'i vi."

Hollmann De la dissolution du jnariage
pour I'impuissance et froideur de PhoQinie ei.
de la femnie. Paris, 1581. Frigidity: Fabr.
Hildani. Cent. V. obs. 40. Gauhius^ Instit.
Pathol. § 820. Lang, Epist. Med. IX.

4. JNCONGRUA. The conceptive power irrespondent to the

constituent principles of the seminal fluid
received. See the preceding genus, sp. 3,
and the note upon it.

Hucher De sterilitate utriiisque sexus, Lib.
IV. Colonn. 1688 — Tugcreau Sur Timpuis-
sance de I'homme et de la femme. Par'n,
1611.

5. POLYPOSA. The cavity of the uterus or vagina, or both, so

filled and obstructed by a polypous excres-
cence as to preclude the entrance or action of
the seminal fluid. — See Baillu Morb. An at.
Fasc. IX. pi, 4.

GENUS VI.
^DOPTOSIS.

Protrusion of one or more of the genital organs or ol ex-
crescences issuing from them into the genital passage ; im>
pairing or obstructing its course.
Hysteroptosis. Sauv. Vog. Sag.

Gen. VI. ^DOPTosis. From ut^iUv, '•' inguen," pi. «<^e<«, " pu-
denda," whence ««^ftr5, "pudor:" and ^t^o-/?, " casus, lapsus."" In-
like manner Sauvages and Sagar use yEf/opsop/na, applying the term
to the urethra as well as the uterus. .Sauvages, howevei', expr§^es
the present disease, but far less correctly, by hysteroptosis j.-C^tMs,
with strict propriety, can denote only one of the speGiQ&'^t^ii'fiil

within its range, namely, displacement of the uterus. ,3

%.

%

il6 NOSOLOGY. [CL. -V.-OH. II

l.uTERi. Protrusion of the uterus into the vagina.-
Prolapsus uteri. Procidentia uteri. Auct.
Aftaden zihdan. Pers,
Chute de la matrice. F. •-

Failing down of the Womb.

tc Simplex. The uterus retaining its proper posture and
figure. •

Different names are frequently given to different
degrees of this variety. If the descent be only to the
middle of the vagina it is called relaxatio uteri; if to
the labia?, procidentia ; if lower than the labise, pro-
lapsus.

See Baillie Morb, Anat. Fasc. IX. PI. 5.
S Retroversa. The uterus displaced, and the lower
part becoming the upper.
Retroversio uteri. Auct.
Renversement de la matrice. F.
Retroverted Womb.

Mostly limited to a state of pregnancy.
V Inversa. The uterus displaced and turned inside out.
Inversio uteri. Auct.
Inversion de la matrice. F.
Inverted Womb,

Mostly produced by unskilfully and violently pul-
ling away the placenta after delivery. See Baillie. as
above.

2. vAGiNiE. Protrusion of the upper part of the vagina into the

lower.
Hysteroptosis vaginae prolapsus. Sauv.
Prolapus vaginae. Auct. Var.

This, like the descent of the uterus, may, according
to the degree of the disease, be relaxation, procidence,
prolapse, or complete inversion.

3. VESICA. Protrusion of the bladder into the urethra.

Exocyste. Sauv.

Prolapsus vesicae. Auct. Var.

Renversement de la vessie urinaire. JVW. Obs.

1. Mdoptosis uteri. Dr. Denraan alludes to an accidental rciro^ec-
ti.on of the uterus, the fundus being turned backwards and outwards
between the rectum and vagina whilst the os uteri remains in its
proper situation. He never met with such ;t ra=e, however, nor
heard of more than one instance.

iiE.M.] ' NOSOLOGY. 317

« Tunicis interioris. The inner membrane being pro-
truded.
Exocyste Noeliana. Sauv.

So denominated from M. Noel, who first accurately
described it.
C Colli. The neck of the bladder being protruded.
Exocyste Solingeniana. Sauv.

Denominated after M. Solingen, who first accurate-
ly described it.

4. coMPLicATA. Protrusion of different organs complicated with

each other.
Hysteroptosis composita. Sauv.

K Utero-vesicalis. Of the uterus dragging the bladder

along with it.

Procidentia uteri vesicara deorsum abripientis. Sauv.

^ Vagino-vesicalis. Protrusion of the vagina dragging

the bladder along with it.

Prolapsus vaginae vesica m deorsum abripientis. Sauv.

5. poLYPosA. Polypous excrescence in the course of the geni-

tal avenue : soft, compressible, red or reddish.
Often, though not always, a cause of barren-
ness. See Sp. 5 of the preceding genus.
« Uteri. Issuing with a slender root from the fundus of
the uterus, and more or less elongating into the
vagina.
Cercosis. Aefii.
Sarcoma Cercosis. Sauv.
Polypus uteri. Baillic.
Polypus of the Womb.

The substantive polypus should be restrained to a
fleshy excrescence of the nostrils. See note on Poly-
pus, CI. II. Ord. I. ^
^ Vaginae. Issuing from the sides of the vagina; broad
and bulbous.
Polypus of the Vagina.

•"^1^* NOSOLOGY. [CL. \ .-OR. III.

ORDER IIL

CARPOTICA.

^ AFFECTING THE IMPREGNATION.

Irregularity, difficulty or danger produced by parturition.

GENUS I.
PARACYESIS.

The progress of pregnancy disturbed or endangered by the
supervention of general or local disorder.
Dystocia Dyscyesis. Young,
Morbid Pregnancy.

1. iRRiTATiVA. Pregnancy exciting distress or disturbance in

other organs or functions than those prima-
rily concerned.
«e Syncopalis. Accompanied with frequent fainting.
C Dyspeptica. Accompanied with indigestion or sickness.
y Dyspnoica. Accompanied with difficult breathing.
i Alvina. Accompanied with derangement of the alvine

canal, as costiveness, diarrhoea, hemorrhoids, &c.
£ Varicosa. Accompanied with venous dilatations of
the lower extremities.

2. UTERiNA. Pregnancy disturbed or endangered by diseased

affection of the uterus.

• A retroversione. The uterus being retroverted. See
(Edoptosis uteri C.

C A leucorrhoea. The uterus secreting, or exciting in
the vagina a secretion of leucorrhoea, so as to pro-
duce debility.

Ord. hi. Cari'otica. From xospjr*?, " fructus," )e«|!T««s, " friii-
tio."

Gen. I. Paracyesis. From w*^*^, "male;" and jef>)<r<j, "gravi-
ditas :" whence kvu, " utero gesto." So in Gen. III. eccyesis, from
ex " ex or extra," and xvntra, as above : and in Gen. IV. pseudocyesh,
from 4^v^»i' " mendaciuni," and Kvnai<;^ as above.

OtE. II.] NOSOLOGY. 319

y Catamenica. The catamenia continuing to recur.

S Hsemorrhagica. Accompanied with hemorrhage. Ca-
tamenia, unaccompanied with hemorrhage, can
scarcely be regarded as a disease. Many menstru-
ate uniformly for the first three or four months of
pregnancy. Some through the whole term, Hagt-
dorn, Cent. II. obs. 94 — A few have never menstrua-
ted at any other time. Hemmann, Med. Chir.
Aussaze — Hopfengdrtner • Uber menschliche Ent-
wikeiungen, p. 71.
3. Abortus. Premature exclusion of a dead fetus from the
uterus.

Amblosis. Auct, GrcKc.

Abortus. Auct, Lat. Sauv. Linn. Sag.

Dystocia abortiva. Young.

Seket. Arab.

Misgeburth. G!

If the exclusion take place within six weeks after

conception it is called,

Blessure. Faux germe. F.

Miscarriage.

If the exclusion take place between six weeks and

seven months, or the term of premature labour, it is

called,

Unzeitige-geburth. G.

Avortement. F.

Abortion.

The fetus said to have been born alive at four months,

A. Reyes, Campus Elys. Quaest. 90. p* 1164 — To have

continued alive when born between five and six months,

Brou2£t, Sur I'Education Medicinale des Enfans, I. 37.

See, for the causes and treatment, "Observations on

Abortions," by John Burns, Glasgow, 1 806.

GENUS II.
PARODYNIA.

The progress of labour disturbed or endangered by irregu-
larity of symptoms, presentation, or structure.
Dystocia. Sauv. Sag. Vog.

320 NOSOLOGY. [CL. V.-OR. HI.

Partus difficilis. Aiict. Var.
Mekhaz. Arab.
Accouchement laborieux. F,
Morbid Labour.

1. ATONicA. Labour protracted by general or local debility.

Lingering Labour.

In the Ephemera JVa/. Curios, is the case of a fetus
illapsing into the uterus after its. head had been denud-
ed, and it had moaned. Dec. I. ann. i. obs. 1. Schol.
obs. 62.

2. SYMPATHETICA. Labour retarded or harassed by sympathe-

tic derangement of some remote organ or
function.
tt Syncopalis. Accompanied with fainting.
C Convulsiva. Accompanied with convulsions.
V Pathematica. Accompanied with great terror, appre-
hension, bashfulness, or other emotion of the mind.
Dystocia a pathemate. Mauriceau. x. 258.

3. iMPLASTiCA. Labour delayed or injured for want of plasti-

city, or unkindly dilatation of the soft parts.
•5 Rigiditatis. The delay confined to a simple rigidity

of the uterus or vagina.
S Haemorrhagica. Accompanied with hemorrhage,
y Lacerans. Accompanied with laceration of the peri-

naeum, or uterus.

4. PERVERSA. Labour impeded by preternatural presentation

of the fetus, or its membrai.'^b.
Dystocia perversa. Young.
Mausil. Arab.

Accouchement contre nature. Mauriceau.
Preternatural Presentation.
Cross-birth.

«6 Faciei. Presentation of the face.
C Natium. Presentation of the breech.
y Pedis. Presentation of one or both feet.
5 Brachialis. Presentation of one or both arms,
s Transversalis. Presentation of the shoulder.
^ Funis prolapsi. Prolapsed naval-string.

Gen. II. Parodynia. From Trx^et, " male," and ahy, or ahv mf,
" dolor parturientis." So *.J<w, " a partu doleo."— The term was
applied by the Greeks figuratively to severe pains of any kind.
The Hebrew hV] was employed still more generally in the same
figurative sense. See Is. xxvi. 18. -ler. xxx. 6.

GE. n.] NOSOLOGY. 321

n Placentae. Presentation of the placenta.
S. AMORPHicA. Labour impeded by mis-configuration of the
fetus or of the maternal pelvis.
Dystocia amorphica. Young.
a A fetu. The fetus deformed by a preternatural mag^'*

nitude of head, or some morbid protuberance-
C Pelvica. The maternal pelvis contracted in its diame-
ter by natural deformity, or subsequent disease or
injury.

Not unfrequently produced by an hydropic or
encysted ovarium occupying a position between
the rectum and vagina, and occasioning an insur-
mountable tumour. See Dr. Merriman's case,
Trans. Medico-chir. Soc. 40. — Recommends exci-
sion.

The German practitioners have often advised
and performed the Cesarean section successfully ;
and, at times, repeatedly on the same woman ; in
one instance not fewer than seven times. Trestan^
Journ.de Medicine, Tom. XXXVI. p. €9.

The division of the symphysis has also been fre-
quently had recourse to with success. See Dema-
ihus Journ. de Med. VIII. 1 — Fischer in Rich-
ter Chir. Bibl. Band. VII. p. 770. See also twice
on the same subject, and successfully, Damen, Lond.
Med. Journ. VIII. 1.
Q, PLURALis. Labour complicated by a plurality of children.
Dystocia geminorura. Young.
Tezauf. Arab.
7. SECUNDARIA. Diseased action or disturbance succeeding de-
livery.
* Retentfva. Retention of the secundines.
Meshim. Arab.

Retained, occasionally without injury, a week, Ha-
gedorn^ Cent. 111. obs. 12 — Sixty days^ Magazino
Toscano, II. 506 — Seventy days, Journal, fvir Gc-
burtshelfer I. n. 8 — Discharged sound and unoffen-
sive in the fourth month, Kerkring, Specileg.
Anatom.
^ Dolorosa. Violent after-pains,
y HffiiTiorrhagica. Violent hemorrhage.

Flooding.
5 Lochialis. Profuse lochia.

Diversified also, occasionally, by the appearance
of fevers of various kinds : sparganosis, or pale ion
41

322 NOSOLOGY. [CL. V.-OR. III.

flammalory swelling of the lower extremities; and
mania : which are rather sequels of labour, or species
or varieties of their respective genera, than species
of parodynia.

GENUS III.

ECCYESIS.

Imperfect fetation produced in some organ exterior to the
uterus.

Dystocia Dyscyesis extra-uterina. Young,
Extra-uterine Fetation,

1. ovARiA. Imperfect fetation occurring in the right or left

ovarium.
Graviditas ovarii. Sauv.

Examples are common. See Ab. Vater Dissert, de
grav. apparente, ex tumore ovarii dextri enormi orta.
per tres annos cum dimidio durante. Wirtemb. Ed.
Med. Ess. v, 336. Ed. Phys. Ess. II. 273. Forrester,
1798, 379. Ed. Med. Journ. II. 180.

One of the most singular cases is that given by Dr.
Baillie, Phil. Trans. 1789. The fetation consisted of a
suetty substance, hair, and the rudiments of four teeth :
the maternal subject not more than twelve or thirteen
years of age, with an infantine uterus, and perfect hy-
men. The whole was evidently unconnected with im-
pregnation, and the ovarium must have been affected
with proeotia. See Order II. Gen. II. of the present
Class.

In the Trans. Medico-chir. Soc. V. IV. 317. Mr.
Barnes of Exeter gives a case of a (ooth contained in
a large tumour extracted from the socket of the eye of
a young man of seventeen.

2. TUBALis. Imperfect fetation occurring in the Fallopian tube.

Graviditas tubalis. Sauv.

Gen. III. EccvEsis See, for its etymology, the note on Gen. I.
above. The disease is common to animals of various classes ; and
may occasionally be paralleled in the vegetable world ; as in the
disorder common to rose-plants, and known by the name of bede-

GE. III.] NOSOLOGY. 323

See Littre, Mem. de I'Acad. R. des Sgav. 1 702. Cy-
prian. Dissert, de fetu ex tuba exciso, 1700. Haller^in
Boerh. v. 329. Santorin Obs. Anat. c. ii. Trans. Soc,
Med.-chir. I. 215.
3, ABDOMiNALis. Imperfect fetation occurring in the cavity of
the abdomen.

See Krohn, Fetus extra uterura hist.
Dentsch ; De graviditate abdominal i. Mtm.
Med. Soc. Lond. III. 1 76. Wrisherg ; Observ.
Anat.

Found in an abdominal cyst in a male-
infant about fifteen months old ; Young,
Medico-chir. Trans. Vol. I. 241. "The
child died after a tedious and painful ill-
ness." The body was opened, and the
cyst examined : the substance it contained
" had unequivocally the shape and charac-
ters of a human fetus."

For want of a regular passage opening
externally, the substance formed, often re-
mains for many years in the extra-uterine
nidus. Walther gives an instance of twen-
ty-two years; Geschichte 4, Berlin 1778.
Bayle a case of twenty-six years ; Phil.
Trans. 1677-1678, Vol. XII. The Ephe^
mera of Natural Curiosities, one of forty-
six years. Ceni. X. Obs. 48.

After the death of the substance, some-
times local irritation takes place, when a
part or the whole is absorbed : or more
generally an abscess is produced, and it is
discharged in separate morsels ; sometimes
per anum ; sometimes by an artificial chan-
nel formed chiefly about the umbilicus or
in the groin. In the former, see Phil.
Trans. Vol. XLV. 1748, Drake. In the
latter, see Phil. Trans. YoL XXIV. 1704-
5, Sir Philip Sheppon, p. 2099.

guar, produced by the deposit of a number of insect-eg-gs in a heap,
chiefly those of the cynips rosa;, in the middle of a bud. The re-
sult is a fleshy mass, often as large as the size of a fist, covered all
over with hair-like processes.

324 NOSOLOGY. [cL. V.-OR. IIJ.

GENUS IV.

PSEUDOCYESIS.

Symptoms of pregnancy without impregnation ; chiefly oc-
curring on the cessation of the catamenia.
Spurious Pregnancy.

1. MOLARis. The uterus irritated by a coagnlum of blood or

other fluid lodged in its cavity, often assuming
a fibrous appearance.
Graviditas molaris. Mauriceau. Sauv.
Myle (MuAjj.) AucL Grc&c.
Mola. Auct. Lat.
Mesket. Arab.
False Conception. Mole.

Frequently exhibiting on being discharged, hydatids
or other vermicles. See, for examples, Marcellus Dona-
tus, Lib. IV. cap. 25. Journ. des Sgavans^ passim.
Ruysch. Obs. 28, 29. Thesaur. III. VI. Evacuated
during dancing, Slevoght, Diss. Fem. mol. labor. Jena?,
1 700.

2. iNANis, The uterus void of internal substance, and irritated

by some unknown morbid action.

The disease is not uncommon ; one of the most
notorious cases in the present day is that of the
pretended prophetess Joanna Southcott.

Gen. IV. PsEunocYEsis. For the etymology, see the note ou
Gen. 1. above. The first species is accounted for by Mr. Hewson
" from the blood's being without motion in the cavity of the uterus,"
and consequently coagulating. " Hence the origin of those large
clots which sometimes come from that cavity ; and which, when
mere condensed by the oozing out of the serum, and of the red
globules, assume a fleshlike appearance, and have been called
moles, or false conceptions." Inquiries^ Part I. p. 27. From the
same inaction probably the formation of what are called polypi of
the uterus.

CLASS VI.
ECCRITICA.

IJISEASES OF THE EXCERNENT FUNCTION,

ORDER I.

MESOTICA.

AFFECTING THE PARENCHYMA.

Pravity in the quantity or quality of the intermediate or
connecting substance of organs : without inflammation, fever,
or other derangement of the general health.

Cl. VI. EccRiTicA. 'E»K^tTi*» : from €K*{<y», " secerno, exhaurio,"
" to secern or strain off, to drain or exhaust." The author has pre-
ferred this derivative to any other which «g(y« affords, as alike ap-
plicable to the secernent and absorbent systems. In the view which
is here taken of these systems they bear nearly the same relation
to each other as the veins and arteries : the action which com-
mences with the one is carried forward into the other. The health
of the general function consists in the balance of power maintained
between the two ; — its disease in the disturbance of this balance.
There may be undue secretion with healthy absorption ; undue ab-
sorption with healthy secretion ; or there may be undue or morbid
absorption and secretion at the same time.

Ord. I. Mesotica. M8(r«{, lonice, (/Hffru-, " niedius," whence
|KSff«9«, uivrtkyt " in medio." This order might have been denomi-
nated parenc%ma<tca, but that there are two objections to the term :
the first is, that 5r«y« is used in this compound in a different sense
from its general signification in the present system ; in the sense of
per or penitus^ instead of in that of perperam ; and consequently the
double signification would trench upon that eimplicity which it is
the direct object of the present nomenclature to maintain.' The
second objection is, that the werd parenchyma {■'r»^^y•K,1'f*»^) is form-

326 NOSOLOGY. [CL. VI.-OR. I.

GENUS I.

POLYSARCIA.

Firm and unwieldly bulkiness of the body or its members,
from enlargement of natural parts.
Polysarcia. Sauv, et Jiuct. Recentior,
Empimelium Polysarcia. Young.
Phoenigmus plethoricus. Sauv.
Dicke. G.
Corpulence. F,
Corpulency.

Vogel makes a disease of the opposite state of body,
which he calls ischnotis, and defines " excessiva corporis
gracilitas :" — " excessive slenderness of body ;" but this
can never perhaps run to a morbid extreme, unless
arising from some species of marasmus.
1. ADiPosA. Bulkiness from superabundant accumulation of
fat.
Polysarcia adiposa. Sauv,
Polysarcia faginosa. Forest.
Obesitas. Darwin.
Simen. Arab.
Feiste. G.
Grosse-panse. F.
Obesity.

ed upon a false hypothesis invented by Erasistratus, who first em-
ployed the term, and who held that the common mass or interior
substance of a viscus is produced by concreted blood,' strained off
through the pores of the blood-vessels which enter into its general
structure or membranes. See Gal. Simpl. Med. I. 11.

For the reason why physconia is not allowed a place in the pre-
sent order, as also for the abandonment of the term altogether, see
the note on Parabysma, CI, I. Ord. III.

Gen. I. Polysarcia. iToAuo-agKi*, "corpulentia," iraAwj-a^**?, "car-
nosus," " came abundans." " Corpulency," says Dr. Darwin, II. ii.
3. 17, '' may be called an anasarca, or dropsy of fat, since it must
be owing to an analogous cause ; that is, to the deficient absorption
of fat compared to the quantity secreted into the cells that contain
it." The reasoning is correct, but the term or expression " dropsy
of fat" would be just as improper as " fatness of dropsy" to explain

GE. 11.] ' NOSOLOGY. 327

K Generalis. Extending over the body and limbs.

Sennert mentions a woman, who at thirty-six years
of age weighed four hundred and eighty pounds
avoirdupois ; and a man who weighed six hundred.
Bright of Maldon weighed six hundred and sixteen
pounds ; and Lambert of Leicester considerably
more.

In the JV. Sammlung Medic. JVahrnehm. III. 370, is
the case of a man who weighed eight hundred
pounds. — Carried off by a spontaneous salivation,
Eph. Nat, Cur. Dec. III. ann. v. vi. obs. 65. — By a
fright, Samml. Medicin. Warnehmungen^ Band. VI. p.
444.
C Splanchnica. Confined to the organs or integuments

of the trunk.
Physconia ab adipe subcutaneo. 1° Sauv.

In these cases the abdominal viscera are more or
less buried in masses of fat, and usually accompanied
with scirrhous affections. In the one instance men-
tioned by Sauvages, the limbs and visage maintained
a graceful elegance of shape : in others they wasted
with gradual emaciation.

GENUS II.

EMPHYMA.

Glomeration in the substance of organs. from the produc-
tion of new and adscititious matter : sensation dull ;
growth sluggish.

anasarca. Each of the words has a distinct meaning, and should be
restrained to that meaning alone : dropsy imports liquid bulkiness,
fatness, 'sojlid bulkiness.

The immediate cause of fatness is doubtful, for we are not much
acquainted with the mode by which animal oil is formed in the sys-
tem. Dr. Beddoes ingeniously conjectured that one cause of its
production is a diminution of oxygen in the animal frame. Fat, un-
questionably, contains less oxygen than muscle, and porphyra nautica,
or sea-scurvy, in which the oxygen is perhaps reduced to its small-
est proportion, is never announced by meagreness, but fullness ot

328 NOSOLOGY. [cL.Vl.-OR.fr

Excrescentiffi. Sauv. '■
Ecphyma. Young »
Tuber. Parr.
Tuberculum. Plenck.

Sila ; {Arab,) whence silat " ganglion, glans indurata,
struma." The Persian term is amas, " aggregatio,
glomeratio, tumor, inflatio:" the verb is araasiden
" intumesco, aggrego ;" the participle amasa " tumes-
cens, aggregans : running directly parallel, with the
French " amasser," and the English verb " to amass,"
and probably derived from a common root.
Knote. G.
Tumour. Abernethy.
I. Saecoma. Tumour immoveable ; fleshy and firm to the
touch.
Lahm. Arab.

Sarcoma. Sa7j,v. Linn. Vog. Sag. Cull.
Ecphyma Sarcoma. Young.
Sarcomatous Tumour. Abernethy.
« Vasculosum. Vascular throughout : texture simple ;
when bulky, mapped on the surface with arbores-
cent veins. Found over the body and limbs ge-
nerally.

habit, which is often its first symptom. It is observed by Dr. Trot-
ter, that when a negro becomes rapidly corpulent, he never fails to
fall a prey to sea-scurvy. According to Saussure and Humboldt,'
the atmosphere of high mountains contains less oxygen than that of
lower regions, which explains why Condamioe was attacked with
scorbutic symptoms on the summit of Pinchina.

Gen. II. Emphyma. Eftpv/nx: from tf*,(pv», " ingenero." Phyma
in the present system is limited to cutaneous tumours accompanied
with inflammation. See CI. HI. Ord. II. Emphyma imports, in
contradistinction to phyma, a tumour originating below the integu-
ments, and unaccompanied with inflammation, at least in its com-
mencement ; while ecphyma, in Ord. III. of the present class, im-
ports, in contradistinction to both, mere superficial extuberances,
confined to the integuments alone. Phyma, however, as Veil as
the term tumour, has been used in a very loose sense by medical
writers, and even by nosologists ; and made to signify a multitude of
swellings that have no resemblance to each other, excepting in a
preternatural hardness or prominence of the part in which they oc-
cur : see the note on phyma, CI. III. Ord. II. The inconvenience
of this generalizing diction has been forcibly pointed out by Mr
Abernethy in his valuable tract on Tumours : and Emphvma is her*-.

GE. II.] NOSOLOGY. 329

Common vascular, or organised Sarcoma. Ahernelky,

Often found of an enormous size in the scrotum,
constituting the sarcocele, or hernia carnosa of au-
thors. Negroes are peculiarly subject to this affec-
tion, and more frequently on the right than the left
side. Tn one instance the tumour weighed bO\h.
Phil. Trans. 1783. Vol. LXXIII. Schotle.

intended to run nearly parallel with Tumour, as explained in his de-
finition of the term ; and consequently to include, with a slight excep-
tion or two, the diseases which he lias distributed under this head : the
chief difference being in exchanging carcinoma for scirrhus in the
genus sarcoma ; the former, when importing an original disease,
being regarded in the present system as constitutional, and conse-
quently appertaining to CI. III. Ord, IV. where it will be found un-
der the term Carcinus; and when originating from an irritated and
ulcerated simple scirrhus, belonging to the same class and order un-
der the genus and species Ulcus vitiosutn : to which the reader may
turn. Carcinus, on account of its virulence, has been correctly
placed last in the list by Mr. Abernethy ; but scirrhus, in its simple
state indolent and insentient, should be placed considerably higher,
and hence is enumerated fifth in order under the pi'esent arrange-
ment. The term encystis, and indeed the common names ibr its
varieties, are drawn from V^ogel, whose subdivisions are nearly pa-
rallel with those of our own countrymen. Dr. Aikin, Mr. Sharp,
and Mr. Abernethy. Mr. Sharp regards ganglion " as an encysted
tumour of the meliceris kind." The meaning is sufliciently clear,
and the general idea sufficiently correct. Kind, however, is a loose
word: they are both varieties of the same species, and are here
arranged as such. The term gloineratioji, or" heaping into a ball,"
an the generic definition, is preferred to protuberance or extuberance,
because some tumours or emphymata lie so deeply seated below
the integuments as to produce no prominence whatever, and are
only dis^coverable by the touch.

The terms tuber, protuberance, and extuberance, have a primary
reference to a similar affection in the vegetable world ; which con-
sists in those knobs or swellings which are so frequently met with
on the trunks, and sometimes on the buds of trees; in the former
rase hard and fibrous ; in the latter, for the most part fleshy and
spongy; and in both produced by the deposit of new matter and
the formation of new vessels; sometimes perhaps produced by lo-
cal disease in consequence of a sudden change of weather, '^nd
sometimes by the irritating puncture of insects. They grow ocea-
sinnaliy to an enormous size without the least injury to the tree on
which they are situated : and are technically denominated tuhera
lignorum, or tubera geminarmn, according to their situi't'ou. In
fruits, and particularly apples, we often meet with a similar affection
42

330 NOSOLO9Y. [CL. VI.-OR. I.

C AdiposLim. Suetty throughout : inclosed in a thin
capsule of condensed cellular substance ; connect-
ed by minute vessels.
Adipose Sarcoma. Ahtrndh.

Found chiefly in the fore and back part of the
trunk. In one case weighing 15lbs. when extir-
pated. Ahem. p. 31. — In another 42lbs. Journ,
dejMed. XX. 531.

— In a third 19lbs. dissected from the face. Leske,
Anserl. Abhandl. I. p. 65.
y Pancreaticum. Tumour in irregular masses ; con-
nected by a loose fibrous substance, like the irre-
gular masses of the pancreas.
Pancreatic Sarcoma. Abernethy.

Found in the celkilar substance; but more usu-
ally in lymphatic glands : chiefly in the female
breast.
3 Cellulosum. Tumour cellulose or cystose : cells oval,
currant-sized, or grape-sized, containing a serous
fluid ; sometimes caseous.
Cystic Sarcoma, Ahcrneth.

Found generally, but mostly in the thyroid
gland, testis, and ovarium. Baillie Morb. Anat.
Fasc. VIII. pi. 8. fig. 1. Abern. Obs.

When in the thyroid gland it is called Broncho-
cele, Botium, or Derbyshire-neck. The cells are
here numerous, the fluid often viscid, sometimes
gelatinous. See Baillie Morb. Anat. Fasc. II. pi.
1. — Occurs, as a symptom, in Cyrtosis Cretinismus,
CI. III. Ord. IV. Gen. IV.
t Scirrhosum. Hard, rigid, vascular infarction of glan-
dular folicles; indolent, insentient, glabrous ; some-
times shrinking and becoming more indurated.
Scirrhous Sarcoma. Aberneih.

When irritated tending to a cancerous ulcer.
See Class III. Ord. IV. Ulcus.

Found in glandular structures, chiefly those of
the secernent system. In one instance, on the

2. I. » E. Sarcoma Vasculosiun. The term vasculosum is here
preferred to vasculare, as the suHix osus is uniformly augmont.itive
or intensive ; and in the present instance, therefore, imports not
opjh; vessels, btil numerous vessels. Foi^the same reason celktlosum
HQa^tuberanlosum are preferred to cellutare and luberculare.

GE. II.] vfp NOSOLOGY. 331

breast, which was almost entirely scirrrhous, and
weighed 64lbs. Leske^ Auserlesene Abhandlungen.
I. Th.
^ Mammarium. Tumour of the colour and texture of
the mammary gland ; dense and whitish ; some-
times softer and brownish : often producing, on
extirpation, a malignant ulcer with indurated
edges.
Mammary, or mastoid Sarcoma. Mem.

Found in various parts of the body and limbs.
•] Tuberculosum. Tumour tuberculose ; tubercles
firm, round, and clustering ; pea-sized or bean-siz-
ed; yellowish, or brownish-red; when large, dis-
posed to ulcerate, and produce a painful, malig-
nant, and often fatal sore.
Tuberculate Sarcoma. Aberneth,

Found chiefly in the lymphatic glands of the
neck; often, simultaneously, in other glands and
organs, Aberneth. p. 47. Baillie Morb. Anat.
Fasc. V. pi. 2.
I Medullare. Tumour of a pulpy consistence, and
brain-like appearance ; whitish ; sometimes reddish-
brown ; when large, apt to ulcerate ; and produce
a sloughing, bleeding, and highly dangerous sore.
Medullary Sarcoma. Aberneth.
See Baillie Morb. Anat. Fasc. VIII. pi. 7.

Found in different parts, chiefly in the testes ; at
times propagating itself along the absorbent vessels
to adjoining organs.
.2. Encystis. Tumour moveable: pulpy, often elastic to the
touch.
Encystis. Vog. Parr.
Lupia. Sauv. Cull.

Encysted Tumour. Sharp. Aikin. Abernethy.
Wen.

X Steatoma. An encysted extuberance containing a
fatty or suetty substance, apparently secreted from
the internal surface of the cyst.
Steatoma. Sharp.

Found over most parts of the body ; and weighing,
from a drachm or two, to twenty or thirty pounds ; — in
one instance, described by Rhodius, sixty pounds.
S Atheroma. Encysted extuberance containing a mealy

33% NOSOLOGY. ^ {CL. VI.-OR. I.

or curd-like substance, sometimes intermixed with
harder corpuscles ; apparently secreted as the last.
Found, of different sizes, over most parts of the
body.
Mollusc um. Willan.
y Meliceris. Encysted extuberance, containing a honey-
like fluid.

Found, of different sizes, over most parts of the
body.
3 Ganglion. Encysted extuberance containing a colour-
less fluid ; the extuberation fixed upon a tendon.
Tcstiido. Encysted extuberance containing a fluid
readily hardening into horn or nail ; and especially
when protruded externally upon an ulceration ot
the surrounding .integuments.
Testudo. Voffel. — See also Aberneth p. 90, and Sir
Everard Home's Cases of horny excrescences from
the human body.
3, Exostosis. Tumour inelastic ; often immoveable ; hard and
bony to the touch.
Exostosis. Sauv. Sag. Linn, Cull.

Ostea. Immoveable; protuberant; seated on the
substance of a bone.

Sometimes excrescent, and composed of bony spi-
cula resembling crystallizations. Sometimes exqui-
sitely hard and glabrous, resembling ivory. Both
found chiefly in the bones of the cranium. See Bail-
lie Morb. Anat, Fasc. X. PI. 1. fig. 1. 2.
C Periostea. Immoveable; protuberant ; from bony en-
largement of the periosteum.

y Pendula. Bony tumour " hanging pendulous into a
joint." Ahernethj on Tumour, p. .102.

^ Exotica. Bony tumour moveable or immoveable,
seated in some fleshy part of the boJy. See Aber-
nethy, ut supra. Perhaps only a variety of osthcx-
ia infurciens ; for which see the next genus.

Several of these varieties, or rather dispositions
to an undue secretion of ossific matter, appear oc-
casionally to depend upon some disorder of the
chylopLiictic viscera. See Aberneth. " On Diseases
resembling Syphilis," p. 85.

«;e. ml NOSOLOGY. 333

GENUS III.

PAROSTIA.

Bones untempered in their substance ; and incapable of af-
fording their proper support.

Nei<es. Arab, Literally " os emedullatum ;" " os ener-
vatum."

1. FRAGiLis. Substance of the bones brittle and apt to break

on slight exertions, with little or no pain.
Fragilitas ossiuni. Auct. Var,
Fragile vitreum. Auct. Var.

Most frequently an attendant on advanced age. Found
also, at times, as a symptom in lues, struma, and por-
phyra : occasionally a sequel of small-pox ; Baltha-
zaar^ Chirurgische Wahrnehmungen. — In one instance
ascribed to a more than usual portion of medul-
lary oil: SaHlant, Hist, de la Societe Royale de Medi-
cine. Tom. VII. p. 316.

2. FLEXiLis. Substance of the bones soft; and apt to bend,

and become crooked on slight exertions with

little or no pain.
Malacosteon. Vog.
MoUities ossium. AucL Var.

Gen. III., Parostia. From w«g«, " perperam," in which sense
it is always used in the present work, and tanof, " os, ossis " The
genus is new, but seems called for: and the species evidently de-
pend upon an inaccordant secretion of the earth of bones compar-
ed with their other principles : this being redundant in the first, and
deficient in the second. In advanced age, the secretion of animal
oil is apt to fail before that of animal earth ; while, not unfrequently,
we find this last existing in organs which give few or no proofs of
it in earlier life. Hence the blood-vessels become not merely rigid,
but in some cases ossific, and the bones more hard and fragile.
The author was once present at a church, in which a lady of nearly
seventy years old, in good general health, broke both the thigh-
bones in merely kneeling down ; and on being taken hold of to be
carried away, had an os humeri also broken without any violence,
and with little pain. It was in the winter-season, and the cold
might have added to the general rigidity. Under the influence of
a warm bed, and a diluting regimen, the bones united in a few
weeks.

334 NOSOLOGY. [CL. VI.-OR. I.

Osteosarcosis. Macb. et Auct. Alior,
Spina ventosa. Auct^Var.

Found also, occasionally, as a symptom in porphy-
ra, diabetes, and some species of colic. See various
cases in Phil. Trans, by Bevan, Pott, Hosty, Pringle ;
as also Gooch, Surg. p. 178: and Bromfitld, Chirurgical
Observations. — Found at times in new-born infants,
more or less general. — Universal, with perversion of
most of the bones ; Morand, Histoire de la Maladie sin-
guliere et de I'examen du cadavre d'unefemme (Sapiot)
devenue tout-a-fait contrefaite par une ramollissement
general des os. Paris, 1752. — In a young man of
seventeen ; Thomason, Journ.de Medicine, Tom. XLIII.
— In a lioness; Eph. Nat. Cur. Dec. I. ann. ii. 6. — In an
ox (ribs ;) Bircherod, Act. Maris Balthici, 1707.

GENUS IV.

OSTHEXIA.

Soft parts more or less indurated by a superfluous secretion
and deposit of ossific matter.
Ossificatio. Plouquet.

Lithiasis in corporis partibus. Cull. Cat. gen. omiss.
1. iNFARciENS. • Ossitic matter deposited in nodules, or amor-
phous masses in different parts or organs.
In the lungs ; Baillie, Morb. Anat. Fasc.

2. Parostia Jlexilis. An analysis of the vertebrae, by Dr. Bostock,
in the case of an adult female, who died of a mollities ossium, in-
dicated that the earthy matter was only one-eighth part of the entire
weight of the bone, instead of amounting to more than half, which
Dr. Bostock estimates to be its common proportion in a state of
health. Medico-chir. Trans. Vol. IV. p. 42.

In the Transactions of the Medical Society of London, Vol. I. p. 169,
is a singular case furnished by Mr. Norris, in which the earthy
matter of nearly half the entire scalp of a woman aged fifty-one,
was gradually carried off by a morbid action of the neighbouring
absorbents, operating at different points, and producing a great mul-
titude of distinct holes or foramina, so as to give the cranium, after
death, the appearance of a sieve. The diseased action was, in
every part, accompanied with a superincumbent inflammation, pro-

GE. IV.] NOSOtOGY. 335

II. pi. 6. — In the substance of the heart,

weighing 2 oz.; Burnet, Med. Pract. III.

254. — In the thymus gland ; Met. Med. Berol.

Vol. I. Dec. iii. p. 28. — In the thyroid ;

Contuli, de Lapid. — In the parotid ; Plater,

Obs. Lib. III. 707. — Sublingual ; common.

— In the deltoid muscle ; Russe, in Blegny

Zodiac, 1680. — In the trachea, contracting

its passage ; Kirkring, Spicileg. Anat. Obs.

27. — In the dura mater ; Baillie, Fasc. X.

PI. 4.

2. iMPLEXA. Ossific matter deposited in concentric layers in

the tunics of vessels or membranes, rendering

them rigid and unimpressible.

« Aortae, Ossification of the aorta.

With a considerable portion of the right ventricle
and right auricle of the heart. Baillie., Fasc. V. PI. 2.
Valves ossified without palpitation or dyspnoea.
Morgagni, De Sed. et. Caus. ep. xxiii. 11.

Descending trunk wholly ossified. Genga, Anat.
^ chirurg. Biickner, Miscel. 1727. p. 305.

Ascending and descending trunks wholly ossified,
compelling to an erect position ; Guattani, De Aneu-
rism.
C Membranea. Ossification of membranous or connect-
ing parts.

ducing tumours in the scalp which were regularly opened, and dis-
charged the contained pus. The only cause that could be traced
was a fall down the cellar stairs about four months before the com-
mencement of the above symptoms, by which the patient struck her
forehead against a heap of wood ; but from which she did not at
the time appear to derive any serious mischief

Mr. Taunton has, among his preparations, the humerus of a man
which to a considerable extent is reduced to a mere cartilage, ancf
was so for a long time during life : the whole of the earthy matter
having been absorbed, and consequently the bone capable of being
bent in any direction.

Gen. IV. OsTHExiA. From •o-reo?, " osseous or bony," and t|«f,
" habitus," " habit." Ossific diathesis, or idiosyncrasy. This mor-
bid affection has been seldom duly attended to in nosological ar-
rangements. It does not occur in Dr. Cullen's classiiication, but.he
notices it in his catalogue of Omitted Diseases, as one of those that
ought not perhaps to have been omitted. Plouquet has arranged
only a very few of the writers on the subject under the article O*,

336 NOSOLOGY. [CL. V[.-OP.. H.

Of the pleura ; Baillie, Fasc. II. PI. 3. '

General ossification of tendons, membranes, carti-
lages and ligaments. PecJdin, Lib. 11. Obs. 40.
y Complicata. Ossification of different parts simultane-
ously.

Thoracic duct, ileum, and other abdominal organs.
Chcsto7i, FhW. Trans. 1780. Vol. LXX.

ORDER IT.

CATOTICA.

AFFECTING INTERNAL SURFACES.

Pravity of the fluids, or emunctories that open into the inter
nal surfaces of organs.

GENUS I.

HYDROPS.

Pale, indolent, and inelastic distension of the body, or i(?
members, from accumulation of a watery fluid in natural
cavities.

Hydrops. Bocrhaave. Machr. Yon}\s.

Hydropcs. Call.

Ord. II. Catotica. From xara, '• infra :" whence y.uTare^»i and -
xxrt*TXTCi^ " inferior and infimus "'

Gen. I. livDROi'S, t5^»i|/ and l^^og. There is no j^cnus of dis-
eases which ha? heen more awkwaidly handled hy the earlier no-
sologists than the present. The term hydrops does not occur in
Sauvages, Linneus, or Sagar, and only once in Vogcl in the com-
pound hydrops scroti. Liuneus connccls anasarca and asfcites, with
tympanites, polysarcia and even graviditas, into osie ordinal division,
which he entitles tvm'dosi, and of which those constitute distinct
genera. Sagar arranges all the same under the ordinal division ol
cnchcxiir. Vogcl pursues the same plan with the omission of <?ravi-
ditas, which he docs not chuse to regard as a cachexy. Sauvago*

GE. I.J NOSOLOGT. 337

Phlegmatia. Parr,
Estiska. Arab.
Wassersucht. G.
Hydropisie. F.
Dropsy.
1. CELLULARis. Cold, and diffusive intumescence of the skin,
pitting beneath the pressure of the finger.
« Totius corporis. Extending through the cellular mem-
brane of the whole body.
Anasarca. Galen^ et Auct. Recentior,
Hyposarcidius {'rTravafxiia.) Hippocr.
Leucophlegmatia. Cce/. Aur,
Hydropisie generale. F,
General Dropsy,
C Artuum, Limited to the cellular membrane of the
limbs; chiefly of the feet and ancles, and, mostly,
appearing in the evening.
Phlegmatia. Sauv,
ffidema. Auct. Var,
CEdematie. F.
Edema.

Either species found also, occasionally, as a symp-
tom, in general debility from fever or other causes ; in
suppressed catamenia, or other habitual evacuations ;
in pregnancy ; or a suppressed eruption of exanthems.

employs the term hydropes, but only in connexion with partiales, so
as to restrain it to local dropsies ; so that with him ascites is a hy-
drops ; but anasarca is not a hydrops^ and does not even belong to
the same order ; it is an intumescentia, under which, as in the ar-
rangement of Linneus, it is united with polysarcia and gravitidas,
while hydrops thoracis is an anhelatio^ and occurs in another volume.
Dr. Cullen has certainly, and in a very considerable degree, im-
proved upon his predecessors in this department. After Sauvages,
he takes intumescentia for the name of his order: but divides it in-
to the four sections of adiposae, flatuosae, aquosse vel hydropes, and
solidse : while under the third section (the aquosse vel hydropes) he
introduces all the family of dropsies, whether general or local; in-
stead of sending them, with those who preceded him, to different
quarters. It would, however, have been a much greater improve-
ment, and have added to the simplicity he aimed at, to have em-
ployed hydrops as a generic, instead of hydropes as a tribual or
family terra ; and the only evil we should then have had to complain
of, would be the use of intumescentijE as an ordinal banner, for dis-
eases that have no possible connexion whatever, nor any kind of re-
semblance, except in an enlargement of external parts. It ig to
43 ; ,

338 NOSOLOGY. [CL. VI.-OR. H.

y Dyspnoica. Edematous swelling of the feet; stiff-
ness and numbness of the joints ; the swelling ra-
pidly ascending to the belly, with severe and.
mostly, fatal dyspncea.
Anasarca cacotrophica. W, Hunter, Essay on Dis-
eases incident to Indian Seamen.

2. CAPITIS. Edematous intumescence of the head ; the suture?

of the scull gaping.
Hydrops capitis. Young.
Hydrocephalus. Sauv, et Auct, Recent.
Hydrocephale. F.
Dropsy of the Head-

Contained twenty-four pounds of liquid, Eph. Nat.
Cur. Dec. III. ann. i. obs. 10. — Continued twenty-four
years. Id. Cent. I. II. obs. 29. — Thirty years, Van Swiet.
ad. § 1217. Boerh. Aph. — Twenty-nine years, with na-
tural pupil, appetite, and sound memory, Micha'eiis Med.
Communic. 1. p. 25.

In this species the fluid never jellies ; for the lubri-
cating fluid secreted naturally into the ventricles of the
brain is equally destitute of this property. " I never
saw it jelly even when exposed to heat." Hewson on
the Lymph. Syst. Part. II. 193.

3. SPiNJE. Soft, fluctuating exturberance on the spine ; gaping

vertebrae.

Boerhaave that we are first indebted for the use of hydrops as em-
ployed in the present method ; and he has been followed by Dr.
Macbride and Dr. Young with a just appreciation of his correct-
ness.

1. Hydrops cellularis. The fluid discharged upon tappiijg is often
of different kinds, not merely from different organs, but, in different
cases, from the same organ : being sometimes nearly as thin as wa
ter, and not coagulating when exposed to heat, which only renders
it turbid, while at other times it flows in a viscid or ropy state, and
accords, upon exposure to heat, with the natural serum of the blood.
The causes of dropsy must, therefore, be different in different cases.
Increased secretion, impeded absorption, or the rupture of a lym-
phatic vessel, may each of them form a cause of itself: but in all
these instances the fluid should be only an accumulation of that
which naturally moistens the cavity from which it is discharged.
Morbid collections of water must proceed from some other cause ;
probably from the exbalent arteries being themselves so altered by
disease as to chanije the properties of the fluid which passes
through them ; or the general mass of blood being so attentuate, or

OE. I.] NOSOLOGY. 339

Hydrorachitis. Sauv* Cull.
Spinola. Linn.
Spina bifida. Vog.

Mostly congenital : but sometimes produced in adults.
See Warner's Cases in Surgery. — Occasionally accom-
panied with hydrops capitis.

Congenital : the child alive at five years old, Titsing
apud Van Swieten, ad. § 1218.
4. THORACIS. Sense of oppression in the chest ; dyspnoea on
exercise or decumbiture : livid countenance ;
urine red and spare ; pulse irregular ; edema-
tous extremities ; palpitation and sudden starl-
ings during sleep.
Hydrops pulmonis {'r}f»>4^ 5r«j/^«»«5.) Hippocr. II. T)f.

Morb.
Hydrops pectoris. Auct. Var.
Hydrothorax. Gorter. Sauv. Cull, tt Alior,
Wassersucht des brust. G.
Hydropisie de poitrine. F.
Dropsy of the Chest.

Sixteen pints found lodged ; Act. M'at. Cur, Vol. V.
obs. 34.

In the pericardium found four pounds of ichorous,
sanguineous, and purulent fluid ; F. Hildan. Cent. I. obs.
43.

Several of the preceding symptoms are given on the
authority and accurate observation of the author's friend
Sir L. Maclean of Sudbury. See his valuable " En-
quiry into the Nature of Hydrothorax," p. 5. Dr. Cul-
len has rightly rejected those species as they are called,

in other respects vitiated, as to affect the secretion. In the last
case, dropsy is not a primary disease, but the consequence of some
other, generally perhaps of a morbid liver, spleen, or lungs. See,
on this subject, Mr. Hewson's valuable remarks in his Description of
the Lympathic System, Ch. xiii.

It is observed by Mr. J. Hunter, that " a disease often produces
such weakness as to destroy itself:" in other words, tliat the mor-
bid action ceases from debihty. It sometimes happens, however,
that the strength of the system is completely worn out at the same
time, and the patient dies notwithstanding the disease has given
way. This is particularly exemphfied in the first, fourth, and fifth
of the ensuing species : for there are, perhaps, few practitioners
but have seen at times a sudden cessation of these diseases, an evi-
dent absorption of the water existing in the affected organ, greater

340 NOSOLOGY. [CL. VI.-OR. H.

but which ought rather t©. be called varieties of Sauvages,
which, whether they exist or not, can never be ascer-
tained by the symptoms, as hydrops mediastini, pleurae,
pericordii, hydatidosus.

Found also, occasionally, as a sequel on fevers, or re-
pelled cutaneous eruptions.

Cured by tapping, Moreland, Phil. Trans. Vol. LVI.
1766. — Another successful use of the same operation in
Purman. Chirurgischen Lorbeerkranz, &c.^427 lb. of
fluid evacuated by tapping within ten months, Morand^
Vermischte Schriften, Band II. — 150 lb. evacuated at
once, T'o2zei<i, Raccolta prima, &c. n. 1. Within twen-
ty-five years, by 80 tappings, evacuated 6,631 pints ; in
one year alone 495 pints, Aus. Ahh. fur pract Aerzte^
Band XI. p. 659.

The fluid commonly, perhaps always, jellies upon
exposure to heat.
5. ABDOMINIS. Tense, heavy, and equable intumescence of the
whole belly ; distinctly fluctuating to the
hand upon a slight stroke being given on the
opposite side.
Hydrops abdominis. Aucl. Var,
Askites. Trallian.
Ascites. Sauv, Linn, CulL et Alior,
Heben. Arab.

Wassersucht des bauches, G.
Ascite. F.
Dropsy of the Belly.

ec Atonica. Preceded by general debility of the con-
stitution. Often the result of scurvy, or fevers of
various kinds.
Z Parabysmica. Preceded by or accompanied with
oppilation or indurated enlargement of one or more
of the abdominal viscera.
y Metastatica. From repelled gout, exanthems, or oth-
er cutaneous eruptions.

freedom of breathing, and even regularity of pulse ; while the ge-
neral weakness has been so considerable that the vital powers have
been incapable of permanently rallying, and the patient has died a
few days afterwards.

1. y H. cellularis Dysptwica. This very severe and singular va-
riety is taken from Mr. W. Hunter's Essay, published at Bengal, fo-
lio, 1804. The disease appeared with great frequency among the
Lascars in the Company's service in 1801. Its attack was sudden,

<5E. I.] - NOSOLOGY. 341

Gmelin informs' us, that abdominal dropsy is
•' treated with great success in Siberia by a decoction
of the drastic herb named by Linneus cimicifuga
fmida^ from its being offensive and poisonous to the
insect from which it takes its name. Flor. Sib, iv.
183.

In the second variety the viscus most frequently
affected is the liver; the gall-bladder of which is
often enormously enlarged and turgid. See PhiL
Trans. 1710-12. Vol. XXVII. Yonge, Mem. de
Paris, 1701, p. 103. Du Verney, Act. Erud. Lips.
1713. In the last, the bladder weighed ten pounds
twelve ounces, had no meatus, contained various
tunics, and was filled with a coffee like liquor.

The substance of the liver is often found loaded
with hydatids. In one instance it weighed twelve
pounds. GoocWs Cases, &c. p. 1 70.

The quantity evacuated by paracentesis has
amounted to 68 lbs. ; Epliem. J^at. Cur. Dec. I. ann.
ix. X. obs. 102. — The operation performed forty-
six times, Nov. Act. Cur. Vol. V. obs. 44. — Patient
cured after twelve operations, Commen. Lit. Nord.
1735.

It has often been naturally cured by some vica-
rious discharge : the most common are profuse
perspiration and diarrhoea.

6. OVARII. Heavy intumescence of the iliac region on one or

both sides; gradually spreading over the belly;

with obscure fluctuation.
Hydrops ovarii. Young.
Ascites ovarii. Sauv. Parr.
Ascites saccatus. Cull.
Dropsy of the Ovarium.

7. TUBALis. Heavy, elongated intumescence of the iliac re-

gion, spreading transversely ; with obscure
fluctuation.

and its course so rapid, that it frequently killed the patient in two
days. From the description, it does not seem to have been con-
nected with a scorbutic diathesis : and Mr. Hunter ascribes it to the
concurrent effect of breathing an impure atmosphere, suppressed
perspiration, want of exercise, and a previous hfe of intemperance.
All these must, unquestionably, have been auxiliaries, and formed a
remote cause, but the immediate cause remains still unexplained.

342 NosoLOdii:. [ce. vi.-or. ii.

Dropsy of the Fallopian tube, Baillie, Morb. Anat. Fasc;
IX. pi. 8. fig. 1.
9. UTERI. Heavy, circumscribed protuberance in the hypo-
gastrium, with obscure fluctuation ; progressively
enlarging, without ischury or pregnancy.
Hydrops uteri. Sennert, Young.
Hydrometra. Sauv. Sag. Cull.
Wassersucht des mutter. G.
Hydropisie de raatrice. F,
Dropsy of the Womb.
9. SCROTI. Soft, semitransparent, pyriform intumescence oi"
the scrotum ; progressively enlarging, without
pain.
Hydrops scroti. Young.
Hydrocele. Heister. Sharp. Cull.
Oscheocele. Sauv.
Oscheophyma. Sag.
Hernie fausse. F,
Dropsy of the Scrotum.

« Vaginalis. The fluid contained in the tunica vagi-
nalis, or surrounding sheath of the testis.
Hydrocele. Vog.
Hydrocele saccata. Auct. Var,
C Cellularis. The fluid contained in the cellular mem-
brance of the scrotum.
Hydrops scroti. Vog.

GEIN US II.
EMPHYSEMA.

Elastic, and sonorous distension of the body or its meai>
bers, from air accumulated in natural cavities.

Gen. II. Emphysema. 'Efii(pvam»i from (pvoxm^ " inflo," " flatu
distendo." There is some doubt by what means the air is produced
in various cases in which it is found in great abundance ; for we
cannot always trace its introduction from without, nor ascribe it to a
putrefactive process. " In one instance (observes Mr. J. Hunter) I
have discovered air in an abscess which could not have been re-
ceived from the externa! air ; nor could it have arisen from putre-
faction." Jinim. Econ. p. 207. The case is singular, but too long

GE. II. J ; _ NOSOLOGY. 343

Emphysema. Gal. Dioscor. Young. Parr.

Windige wassersucht. G.

Inflation.

Wind-dropsy.

1. CELLULARE. Tcnse, glabrous, diffusive intumescence of the skin,

crackling beneath the pressure of the finger.
Emphysema cellulare. Young.
Emphysema pneumatosis. Parr.
Pneumatosis. Sauv. Cull.
Empneumatosis. Ccel. Aurel.
Sarcites flatuosus. Smetii.
a A vulnere. From a wound of the thorax.

Pneumatosis a vulnere. Sauv.

Pneumatosis traumatica. Cull.
C A veneno. From fish-poison or other venom.

Pneumatosis a veneno. Sauv.

Pneumatosis venenata. Cull.

2. ABDOMINIS. Tense, light, and equitable intumescence of the

whole belly; distinctly resonant to a stroke

of the hand.
Hydrops siccus et flatulentus. Hippocr. Fcesii. Aph. ii.

§4.
Tympania. Galen.
Tympanita. Sennert.
Tympanites. Sauv. et Auct. Recentior.
Emphysema tympanites. Parr.
Emphysema tympaniticum. Young.
Windige wassersucht des bauches. G.
Tympanite. F.
Tympany.

The tympanites intestinalis of authors, like the meleoriss
mus of Sauvages, is a variety, sometimes only a symp-
tom, of dyspepsy, worms, hysteria, or some other dis-
ease affecting the intestinal canal.
The very singular case of Margaret Dog, related by

to be copied. From this and various other circumstances, Mr. H.
adopted the opinion that air is often secreted by animal organs, or
separated from the juices which are conveyed to them : and he ap-
peals, in confirmation of this opinion, to the experiments of Dr. In-
genhouz upon Vegetables. The experiments of Count de Miilly
on the human body in favour of the same opinion, published in the
Berlin Transactions for 1777, are not to be depended upon; as Dr.
Pearson has since shown that thev were made without sufficient

344 NOSOJLOGY. [CL.VI.-0R. 11.

Dr. A. Munro in the Edin. Med. Essays, Yo\. I. xxxi,
seems to have been of .a mixed character, a real tympany,
with irregular inflations of different parts of the alvine
channel.

Found, also, occasionally, in the last stages of ente-
ritis, and several species of hernia, from evolution
of air in consequence of putrefaction.
3. UTERI. Light, tense, circumscribed protuberance in the hy-
pogastrium ; obscurely sonorous ; wind occasion-
ally discharged through the mouth of the uterus.
Physometra. Suuv. Sag. Cull.
Hysterophyse. Vog.
Emphysema uterinum. Young.
Inflatio uteri. Sennert.
Windige wassersucht des mutter. G.
Tympanite de la matrice. F.
Tympany of the Womb.

GENUS III.

PARURIA.

Morbid secretion or discharge of urine.
1 iNOPs. Destitution of urine ; without desire to make watei .
or sense of fulness in any part of the the urinary
track.
Ischuria notha. Sauv.

Gen. III. Paruria. From ^a^x, " perperam," and it/jia, " min-
go." The genus is intended to include the ischuria, dysuna, pyuria,
enuresis, and diabetes of authors ; which, like the various species
of the preceding genus, lie scattered, in most of the nosologists,
through widely different parts sf the general arrangement. I'hus,
in Culien, diabetes occurs in CI. 11. Ord. III. neuroses, sfasmi : enuresis
in CI. IV. Ord. IV. locales, apocenoses : and ischuria, and dysuria in CI.
IV. Ord. V. locales epischeses. All these form a natural group : and
the two last have characters scarcely diversilied enough for distinct
species, instead of Ibrming distinct genera. Dysuria might have
served well enough as the generic term for the whole ; but as it
has been usually limited to the third species in the present arrange-
ment, the author has thought it better to propose a new term, than
to run the risk of confusion by retaining the old term in a new sense.

3. 1. P. Stillalitia Helminthica. This TaD.'ly is given upon the
authority of Mr. Lawrence's very singular case inserted in the JWe-

eE. III.] NOSOLOGY. 34<0

Often the result of renal inflammation or paralysis ;
but sometimes a genuine idiopathic affection. Parr relates
a case, that occurred in. his own practice, in which no
urine was apparently secreted -for six weeks; at the
end of which time the discharge returned spontaneous-
ly. See his article Ischuria : as also various similar
cases in the Phil. Trans, particularly Mr. Richardson's
of a boy who never secreted urine.
% RETENTioNis. Urine totally obstructed in its flow ; with a
sense of weight or uneasiness in some part
of the urinary track.
Ischurfa. Paul, ^ginet. Sanv. Gull. Plouquet,
Esr. Arab. It is also applied to the next species.
Retention d'urine. F.
Stoppage of Urine.

» Renalis.. Pain and sense of weight in the region of
the kidnies ; without any swelling in the hypogas-
trium.
Ischuria renalis. Sauv. Cull.

Sometimes accompanied with suppurative inflam-
mation, and enormous enlargement of the organ. Pu-
rulent, and weighed Hlb, Cabrolii^ Observ. n. 28.

Sometimes accompanied with parabysma or coa-
cervation, and still larger. Weighed 25lb. Commerc.
Later. J^or. 1 737, p. 326, Another case, same weight.
Hist, de V Academic des Sciences, 1732, p. 45.

The kidney sometimes emaciated, and strikingly
small. Weighed exactly a drachm, IVarthon Adeno-
graphia, p. 96.
C Ureterica. With pain or sense of weight in the re-
gion of the ureters.
Ischuria ureterica. Sauv. Cull.

dicO'Chirnrg. Trans, vol. ii. p. 382. The patient was a female aged
24 : had long laboured under a severe irritation of the bladder,
which was ascribed to a calculus. She at length discharged three
or four worms of a non-descript kind, and continued to discharge
more, especially when the discharge was aided by injections, or the
catheter remaining in the urethra for the night. The evacuation of
these animals continned for at least a twelve-month. Twenty-two
were once discharged at a time ; and the whole number could not
be less than from 800 to 1000. A smaller kind was also occasional-
ly evacuated. The larger vvere usually from four to six inches in
length ; one of them measured eight ; slender in the middle ;, fili-
form at the extremities; thicker in the inter-spaces: they were soft
44

346 NOSOLOGY. [CL. VI.-OR. II.

y Vesical is. With protuberance in the hypogastrium ;
frequent desire to make water ; and pain at the
neck of the bladder: sometimes at the end of the
penis.
Ischuria vesicalis. Sauv. Cull.
J Urethralis. With protuberance in the hypogastrium ;
frequent desire to make water ; and a sense of ob-
struction in the urethra, resisting the introduction
of a catheter.
Ischuria urethralis. Sauv. Cull.

The retention has often continued from a week
to a fortnight. See E/?/i. JVaY. Gtr. passim, Cornarus
Obs. n. 21. Paullini gives an instance of habitual
retention, without injury. Cent. ii. obs. 26. A pro-
tracted case in Haller, Bibl. Med. Pr. ii. p. 200, of
twenty-two weeks. In Marcellus Donatus, lib. iv.
cap. 27, 28, six months: but these were probably
cases of paruria inops, through a considerable peri-
od of these long intervals.

Sometimes the retained urine has regurgitated
through the ureters: Petit, Traite, &c. Oeuvres
Posthumes, Tom. iii. p. 2.

Occasionally the quantity retained has amount-
ed to eight or nine pints. Bird, Medical Observ.
and Tnq. vol. v. In one instance to sixteen pints.
Vilde Journ. de Med. Tom. xlvii. p. 134.
3. STiLLATiTiA. Painful and stillatitious emission of urine.
Stranguria (STjafyoug/*.) Paul. JEgin, et Auct, Grcec,
Dysuria. Sauv. Linn. Vog. Cull.
Harnstrange. G.
Dysurie. F.
Strangury.

a. Spasmodica. From spasmodic constriction of the
sphincter, or some other part of the urinary canal,
catenating with spasmodic action in some adjoin-
ing part.
Dysuria spasmodica. Cull.

Dysuria hysterica. D. rachialgica. D. diabetica.
D. nephralgica. Sauv.
C Ardens. From spasmodic constriction excited by
' the external or internal use of various stimulants,

when first voided, and of a yellowish hue. For the most part they
'vere discharged dead.

r**.

GE. III.]

NOSOLOGY. ,347

as acrid foods, or cantharides; accompanied with a
sense of scalding as the urine is discharged.
J^ysuria ardens. CulL
Djsuria arsura. D. primaria. Sauv.
y Callosa. From a callous thickening of the mem-
brane of the urethra : the stricture permanent.
Baillie Morb. Anat. Fasc. viii. pi. 5.
J Mucosa. The urine intermixed with a secretion of
acrimonious mucus, of a whitish or greenisii hue.
Frequently a sequel of gout, lues, or blenorrhoea :
sometimes produced by cold, and in this case forming
th» catarrhus vesicce of various authors ; so denominat-
ed from its being conceived that the bladder and ure-
thra are affected in the same manner as the nostrils
in a coryza. Where the stricture is permanent and
very narrow, ulceration and fistulae in perinteo arc
frequent results.
Dysuria mucosa. Cull.
Pyuria mucosa. P. viscida. Bauv.
Glus. Linn.
Catarrhus vesicae. Auct. Var.

The one or other of the varieties found also occa-
sionally, or as a'symptom, in inflammation of the uri-
nary organs, several species of lithia, and compres-
sion from local tumours, retroversion of the uterus in
pregnancy, or descent of the child's head in labour.
t Helminthica. Accompanied with a discharge of worms

of a peculiar kind.
^ Polyposa. The bladder or urethra, or both, obstruct-
ed by the formation of a polypous excrescence ;
sometimes shooting to the external extremity.
See Baillie^ Morb. Anat. Fas. vii. ph 4.
4. MELLiTA. Urine discharged freely, for the most part profuse-
ly ; of a sweet smell and taste ; with great thirst,
and general debility.

4. P. Mdlita, (S/aSjjxtjf, " a siphon," from ^laQxtva, " transeo.")
Diabetes, among the Greek and Roman, and indeed among modern
physicians till the time of WiUis, imported simply immoderate flow
of urine : the secretion of saccharine urine never having been no-
ticed till his day : and hence, in Sauvages, it signifies equally imittjo-
derate flow of urine from hysteria, gout, fever, spirituous potation;
or urine combined with saccharine matter. Now the only relation
which the last has to the rest is that of its being usually secreted in
n preternatural quantity • but as this, though mostly, is not always

"■it

348 NosotoGY. [gl. vi.-or. It.

Diabetes. Plouquet.

Diabetes Anglicus. Sauv.

Diabetes Mellitusr. Cull, Cricht. et Aud. Alior.

the case, it has no pretence whatever to the name of diabetes, and
ought to form a distinct division. Or if the name of diabetes be
appUed to it, it should be given to it exclusively. Dr. Young, who
retains the name in the latter sense, and employs it as that of a ge-
nus, justly allows but one species to the genus, diabetes mellitus of
Cullen ; and describes the diabetes insipidus of Cullen under the
genus and species of hyperuresis aqiwsus. There is great doubt
whether this last ever exists as an idiopathic affe^ction. Cullen
himself indeed candidly expresses the uncertainty of his mind upon
this subject : almost all the cases of diabetes of late times, he ob-
serves, exhibit saccharine urine. " ita ut dubium sit, an alia diabetis
idiopathicae et permanentis species revera detur." If such should
be found, it will probably be nothing more than a variety of the
next species in the present arrangement, paruria incontinens.

Diabetes, then, seems properly arranged as a species of i>aruria,
and the common essential name of mellita cannot well be exchanged
for a better. Parr has made diabetes a species of a genus, which
he calls apocenosis, including vomiting, purging, immwderate sweat,
salivation, matted hair, and various other atTections which have lit-
tle natural connexion with each other: and hence diabetes mellitus
sinks into a mere variety of this generic and incoherent cluster.

Concerning the cause of this extraordinary affection we are still
considerably in the dark. The two principal hypotheses that have
been started are contained in the following extract from Mr. Cruik-
shank. " In the diabetes it has been supposed that the chyle flows
retrograde from the thoracic duct into the lymphatics of the kid-
ney ; from them into the cryptae, so into the tubuli uriniferi, thence
into the infundibula pelvis, ureter, and so into the bladder. This
opinion is mere supposition, depending on no experiments ; and, be-
sides that all such opinions should be rejected, why should the
chyle flow retrograde in the lympathics of the kidney, and not in
the lacteals themselves? And why are not the feces fraught with a
similar fluid as well as the urine ? 'J'he arteries of the kidneys are,
on these occasions, prctcrnaturally enlarged, particularly those of
the cryptae or minute glands which secrete the urine : and it is infi-
nitely'more probable that the fluid of the diabetes arises from some
remarkable change in the vessels usually secreting the urine, than
from any imaginary retrograde motion of the chyle through the
lymphatics of the kidneys." On the. Lucicul.i and Lymphatics^ p. G9.

See a valuable paper on the subject of diabetes by Dr. Henry,
Tram. Medico-chirurg. Soc. Vol. II. I'lC, in which the atfected urine
is shown to be of greater specific gravity than in its natural state ;
exhibiting from 1028 to 1010, compared with 1000 parts of water.

GE. III.] « NOSOLOGY. 349

Apocenosis Diabetes mellitus. Parr.
Nufas. jlrab,
5. iNcoNTiNENS. Frequent or perpetual discharge of urine,
with difficulty of retaining it.
Incontinentia urinae. Sennert.
Perirrhoea, (w{5«§p«<«.) Hippocr,
Stranguria. Gal.

Enuresis. Sauv. Linn. Vog. Sag, CulL
Hyperuresis. Young.
Seles. Arab.
Harnfluss. G.
Incontinence d'urine. P.
Incontinence of Urine.

« Acris. From peculiar acrimony in the fluid secreted.
C Irritata. From peculiar irritation in some part of the
urinary channel.
Enuresis irritata. CulL

while natural urine is under 1020. The saccharine matter it con-
tains appears to be of nearly, or altog-ether, the same nature as the
saccharine matter of vegetables. The urme seems also to be to-
tally destitute, or very sparingly possest, of urea or the ammoniacal
secretion. In opposition to the two theories of a mere morbid
state of the secreting organ, and that of the assimilating or diges-
tive function, Dr. Henry conceives that both are in a diseased con-
<]ition.

After Willis had shown that sugar existed in a detached state in
this kind of urine, various analysts endeavoured to ascertain its pro-
portion. Dobson from a pound of urine collected an ounce of sac-
charine matter : Cruikshank from thirty-six ounces troy, obtained
by evaporation not less than three ounces and a quarter ; which,
from the quantit}' discharged by the patient, would have amounted
to not less than twenty-nine ounces every twenty-four hours.

A similar complaint is to be traced amongst plants, though the
author does not remember to have seen it noticed as such by any
physiologist. What the diabetes, honey-water, or honey-urine is to
animals, the melligo or honey-dew seems to be to the vegetable
tribes. In both an ordinary aqueous secretion is for the most part
increased in quantity, and constantly combined with a production of
saccharine matter ; and in both the effect is great debility, atrophy,
and emaciation of the vital frame, 'ihe plant usually recovers, be-
cause the coldness of the winter, that puts a stop to its natural ac-
tions, puts a stop also to those that are morbid : the animal usually
dies, for in him there is no such regular cessation : but in evergreen
plants, which suffer no winter torpitudc, the disease is often as fatal
as among mankind.

350 NOSOLOGY. [€L. Vl.-OR. li.

Discharge of hairs. KlatU de Trichias, Alton.
1703.
y Atonica. From atony of the sphirtcter of the bladder.

Enuresis irritata. : Cull.
% Aquosa. From superabundant secretion ; the fluid

limpid and dilute.
Hyperuresis aquosa. Young.

Variety C found occasionally, also, as a symptom
in pregnancy, catamenia, sparganosis, and lithia. y
in puerperal debility, paralysis, and coma. 5 in hy-
steria, hypocondrias, and other nervous affections.

The quantity discharged has occasionally been
enormous. Sometimes forty pints a day ; DodoncBus,
Obs. Med. exempl. var. cap. 42. — 3674 pints in
ninety-four days ; more than thirty-nine pints a day
for the whole term : Barati, Caso proposto a Ludo-
vico Testi. — 4171 pints within ninety-seven days;
just forty-three pints a day through the entire term ;
Comment. Bonon. Tom. I. — 200 pints daily, time not
mentioned ; Fonseca de Naturae Artisque miraculis,
p. 538.

The honey-dew is, in general, produced suddenly, by a peculiar
haze or mist apparently loaded with a specitic miasm, or other ma-
terial, poisonous to certain kinds of plants, though innoxious to
others. The leaves and often the stems which it infects, as it creeps
along, immediately throw forth an augmented secretion from their
surface, more viscid in texture, and, as just observed, considera-
bly impregnated with sugar. Insects of various kinds are instanta-
neously attracted by the secretion, and particularly different species
of the aphis, or green-louse, which find in this morbid material a
rich harvest of food, and instantly cover every part of the plant
with viviparous or oviparous young, so minute as to be almost invi-
sible to the naked eye ; but which are soon traced in the shape of
innumerable hosts of green lice, whose voracious appetite still far-
ther exhausts the sinking plant, and extends the scene of vegetable
desolation through a wide and dreary range. Such is the sad pic-
ture which has just been presented to the author's eye on visiting
various hop-plantations in the county of Essex, most of which have
been suffering severely, and the greater number of which have lost
the whole of their produce. In several instances he found it not
difficult to trace the course in which the pestilential haze had mov-
ed forward ; for while a few hop grounds lying out of its track, or
merely bordering on it, seemed to have escaped with little compa-

GE. III.] ' NOSOLOGY. 351

.? i

6. iNcocTA. - Urine consisting of fluids taken into the stomach,

and excreted without change.
See Bartholin. Hist. Anat. Cent. I. hist. 68. Sylva-
ticus, Consil. Gent. III. n. 41/42. Trincavel. De Ra-
tione Cur. part. corp. hum. Oil of almonds, without
change; Bachetoni, Comment. Bonon. Tom. 1!. parti.
Prussiat of potass, and apparently without passing
through the circulation ; Wollaston and Marcet, Phil.
Trans. 1811. Rhubarb; Home, Id.

7. ERRATiCA. Urine discharged at some foreign outlet.

Uroplania. .^uct. Var.

K Salivaris. By the salivary glands. Phil. Trans.

passim.
C Cutanea. By the skin. Id.
y Umbilicalis. At the navel. Act. Erudit. 1760.
§ Vaginalis. By a fistulous opening into the vagina.

Valisnerii. Oper. iii.
£ Perinastica. By a fistulous opening into the perinae-

um. Ibid.

rative injury, a few strips of the plantations that were most affected
by it, from the same cause escaped equally ; and, being free from
the malligo or honey-dew, were free also from the assault of the
aphides, that were attracted by it, with a leaf nearly as clean, and a
fruit as sound as if no such disease had existed in the neighbourhood.
The mischief of this little insect is terribly augmented by the curi-
ous faculty it possesses of having various ova impregnated by a sin-
gle copulation ; so that the female is able to breed eight or nine
times in succession without further sexual intercourse ; and by its
breeding oviparousi}' in the colder part of the autumn, by which
the young are defended from the weather, instead of viviparously,
as in the summer.

6. Paruria erratica. This disease has often been described un-
der the name of uroplania (from tv^ov, and ttaxvyittis, erraticus,) but
seldom introduced into nosological arrangements. The cases, how-
ever, are so numerous and distinct, in vvriters of good authority,
tliat it ought not to be rejected. In most instances it is not a vica-
rious discharge ; in other words, a secretion of a diiferent kind
compensating lor the absence of urine, but a discharge of an urin-
ous fluid, apparently absorbed after its secretion by the kidneys,
and conveyed to the outlet from which it issues : of the manner of
which conveyance we are as ignorant as of the mods by \vhich va-
rious substances travel from the stomach to the kidneys, apparent-
ly without passing through the general course of the circulation ot
the blood.

352 NosoLOGv. £gl. VI.-OR. I1-.

GENUS IV.
LTTHIA.

Morbid secretion, or accumulation of calculous matter in
internal cavities.
Lithiasis. Plouguet, Machr. Young.
Morbi calculosi. Sauv. Class. Morb. ^Etiol.
1. RENALis. Pain in the loins shooting down towards the testes
or thighs, increased on exercise ; urine often
depositing a sabulous sediment.
Lithiasis nephritica. Marbr.
Lithiasis renalis. Young.

tt Calculosa. Pain severe and constant ; sabulous dis-
charge small and seldom, or never : calculus usu-
ally Inrge, and obstructing the pelvis of an ureter.
Nephralgia calculosa. Sauv.

See Baillic^ Morb. Anat. Fasc. vii. pi. 5, 6.
S Arenosa. Pain intermitting ; free discharge of a sa-
bulous sediment.
Griess in den nieren. G.

Gen. IV. LiTHiA : from Xittg^ or rather from x*<««, '' calculo la-
boro." The name among the old writers, and which was revived
by Dr. Macbride, and has been continued by several since, was
lithiasis. It is only in the present case altered to lithia, because
iasis is a common termination for diseases aflecting the skin or cu-
ticle.

It is singular that this disease is only indirectly glanced at by most
of the preceding nosologists, and not at all in its first variety, ex-
cept by Sauvages, who alludes to it in his genus nephralgia : while
stone in the bladder, both by himself and Cullen, is reduced to a
mere species, or rather a variety of dysuria or strangury : as though
the peculiar symptoms and general nature of these afl'octions were
not sufficient to constitute a distinct genus. The error, however,
is in both instances, rather to be ascribed to an imperfection in the
respective classifications, than a deficiency in the judgment, of
these celebrated writers.

The name of litbus or lithiasis, as used by Aretaeus and Aurelia-
nus, and that of calculus or sabnium as employed by Celsus and
Pliny, sufficiently evince the elementary princples, of which the
Greeks and Romans conceived urinary calculi to consist. The mis-
take is not to be wondered at when we reflect that it is not till about

GE. IV.] NOSOLOGY. 353

Gravelle. F.

Gravel.

Both varieties found in most quadrupeds. Traced
by Fourcroj in the horse and cat; by the younger
Morand in the rat.
2. VESicALis. Frequent desire of making water, with diffi-
culty of discharge : penis rigid, with acute
pain at the glans ; sonorous resistance fo the
sound when searching the bladder.
Lithiasis cystica. Macbr.
Lithiasis vesicalis. Young.
Dysuria calculosa. Sauv.
Dysuria irritata. Cull.
Calculus vesicae. Senncrf,
Hesat. Arab.
Blasenstein. G.
Calcul de la vessie. F.
Stone in the Bladder,

Voided of the weight of 2 oz. by a female ; Hanoxi-.
Seltenheiten der Natur.- — 2| oz. troy by a female ; MoU.

thirty years since that these principles were detected with any de-
gree of accuracy : and that we are indebted to the minute and ela-
borate experiments of Fourcroy and Vauquelin for an analysis,
which not only Van Helmont, Hales, and Palucci, but even Scheele,^
Bergman, Hartenkeil and Pearson had left unfinished : and which
still required the correcting hands of Wollaston and Berzelius to be
brought to a desirable perfection.

Fourcroy asserts that oxen have urinary calculi in great abun-
dance after dry seasons ; which disappear in spring and summer,
destroyed by the green succulent food whicli is hereby afforded
them ; and he hence reasons upon the advantage of similar food to
mankind in similar casiss. Two of the best essays upon the subject
are those of Mr. Brande on the benefit of magnesia in preventing
an Increased formation of uric acid, published in the Phil. Trans, for
1810, p. 136 ; and 1813, p. 213. In the Transactions of the Acade-
my at Stockholm, a decoction of the beans of the phaseolus radiaius,
and the powder of the uva ursi are recommended by Linnfeus as va-
luable lithontriptics. See Tom. i. 225. Beskrifnig po° et slag Osiin-
diskar Arter. Also id. p. 279, Ron am orsaken til Fallende gotcn i
Skane ock Wernsharad. A milk diet is also strongly advised, from
various cases in which it seems to have been very successfully em-
ployed. Genesis. Calculi. Resp. J. O. Hagstrbm, 1740.

2. [Alhia vesicalis. The shortness and expansibility of the female
urethra not only admits an evacuation of large calculi with little in-

354 NOSOLOGV. [;GL. VI.-OR. III.

neux.- — 5 oz. by the penis ; Sammlung Med. Wahrn,
Band viii. p. 258.

Extracted 12 oz. weight; Cheselden, Anat. — 12 oz. ;
Ephem. Kat. Cur. Dec. 11. ann. v. — 22 oz. Fabr. Hild.
de Lith. vesic. Same weight, cent. iv. obs. 51 : the
patient died during the operation.

Found in the bladder 4-|!b. weight; Brtsl. Sammlung,
1724, ii. 434. 11. In the bladder of a dog l^Ib. Eph.
Xat. Cur. II. Dec. III. ann. v. vi. p. 99. Nearly 5lb.
in the bladder of a horse ; Gattenhof, in Diss, de Cal.
1748. 2—3 oz. Phil. Tr. vol. xv. p. 1015.

The number of 120 of various sizes voided in the
course of three days. Eph. Xat. Cur. Dec. III. ann.
V, vi. — 300 large in two years. Fabr. Hild. cent. i. obs.
69. — 2000 within two years. Griindlicher Bericht vom
Blatterstein.

Resonant; Bresl. Samml. 1724. Woolly; Bartholin.
Act. Hafn. ii. obs. 55.

See for the chemical principles of stone in the kid-
ney or bladder, Phil. Trans. 1797, WoUaston. Id. 1808,
Home and Brande.

ORDER III.

ACROTICA.

AFFECTING THE EXTERNAL SURFACE.

Vravity of the fluids or eraunctories that open on the exter-
nal surface : without fever, or other internal affiection, as a ne-
cessary accompaniment.

convenience compared with that suffered by men, but has often sug-
gested the expediency of introducing the stone-forceps into the blad-
der, so as to supply the place of lithotomy. Mr Thomas, by gra-
dually enlarging It by means of a sponge-tent, was, in one case, able
to introduce his finger into the bladder, and succeeded in bringing
away an ivory ear-pick which had been incautiously used as a ca-
ter, and had slipped into the cavity of the bladder. In another sin-
gular case, the same skilful operator gradually expanded the spincter
•ja^i to a diameter large enough to admit his whole hand into the

OE. I.] 1 NOSOLOGY- .'j5:5

GENUS T.

EPHIDROSIS.

Preternatural secretion of cutaneous perspiration.
Ephidrosis. Hippocr. Sauv. Sag. Cull.
1 . PRorusA. Cutaneous perspiration secreted profusely.
Ephidrosis spontanea. Sauv.
Ephidrosis idiopathica. Cull.
Sudor. Linn.
Hydropedesis. Vog.

Areknak. Pers. Literally " sudor perfusus." Tuj'C.
dtrlu, or, as vulgarly pronounced, terlu.
2. CRUENTA. Cutaneous perspiration intermixed with blood.

rectum, and hereby succeeded in extracting' a large substance that
had sHpped into its channel. Medico- chirnrg. Trails. Vol. i. 124.

Order III. Acrotfca. From «xg«;, " summus," whence axganiTjjj,
" summitas," " cacumen." The genera and species are taken as
nearly as the system would allow from Dr. Willan's Cutaneous
Diseases.

Gen. I. Ephidrosis. 'E^<^g«o-/5, " sudor." The matter of sweat
and of insensible perspiration is nearly the same ; the former con-
sisting of the latter Avith a small intermixture of animal oil. It is
affirmed by some writers that there are ]>ersons who never per-
spire. This is doubtful ; for all warm-blooded animals either per-
spire by the skin, or have some vicarious evacuation that supplies
its place, as in the case of the dog kind, in which an increased dis-
charge of saliva seems to answer the purpose. In cold-blooded
animals we sometimes find partial cutaneous secretions, as in the
lizards, the exudation from some of which, particularly the lacerta
Geitja of the Cape of Good Hope, is highlj' acrid, and occasionally
produces dangerous gangrenes. Generally speaking, however, cold-
blooded animals secrete but a small quantity of fluid on the surface,
and hence suifer but little exhaustion or diminution of weight in
long periods of time, and can live long without nourishment. And
it is hence probable that, among mankind, those who throw off but
a small portion of halitus, may exist upon a very spare supply of
food; which may afford a solution to many of the wonderful cases
of fasting persons recorded in the scientific journals of dilferent
countries: for the matter of insensible perspiration is calculated,
upon a fair average, as being daily equal in weight to half the food
introduced into the stomach in the course of the day. Thus if a
man of good health and middle age and stature, weighing about
146 pounds avoirdupois, eats and drinks at the rate of fifty-si:^ ■^"

356 NOSOLOGY. [CL. VI.-OR. III.

Sudor cruentus* ..^Ub^Yt, Wcdcl.
Sudor sanguih«asi ! Jantke. Minadoi.
Haemalidrosis. Plouquet.

This species has not been very commonly noticed by
nosologists; but the cases of idiopathic affection are so
numerous and so clearly marked by other writers that
it ought not to be passed over. It has sometimes occur-
red during coition. Paulini cent. iii. obs. 46. Some-
times in new-born children. Eph. J^at. Cur. Dec. ii.
ann. obs. 65. Another case, obs. 179. Other cases of
it\ secretion during coition, Ann. vi. Appendix, p. 4. 43.
53. From fear, Sldhl Diss, de Passionibus. Hallas,
169U

3. PARTIALIS. Cutaneous perspiration limited to a particular

part or organ.
Ephidrosis lateralis. Sauv, who quotes from Schmidt,
Collect. Acad. iii. 577, the case of a woman who was
never capable (except when pregnant) of being thrown
into a sweat in any other part than the left side.

4. TiNCTA. Cutaneous perspiration possessing a depraved

colour.
» Viridis. Of a green tinge. Sauv. Borelli. cent. ii. 56.
€ Nigra. Of a black tinge. Sauv. Joel. Langelot.

Collect. Acad. HI. 255.
y Caerulea. Of a blue tinge. Sauv. Winder. Collect.

Acad. III. 263.
3 Rubra. Of the colour of port-wine. Sauv. BarthoL

5. oLENs. Cutaneous perspiration, possessing a depraved

smell,
a Sulphurea. Of a sulphurous scent. Ephem. J^at. Cur.
Cent. I. II. obs. 168.

ounces in twenty-four hours, he will be commonly found to lose
about twenty-eiorht ounces within the same period by insensible
perspiration; sixteen ounces during the two-thirds of this period
devoted to wakefulness, and twelve ounces during the remaining
third devoted to sleep.

It sometimes happens that this evacuation is secreted in excess,
and becomes sensible, so as to render the whole, or various parts
of the body, and especially the palms of the hands, covered with
moisture, without any general alVection of the system. And it is to
this species that the term ephidrosis has been usually applied and
limited by nosologists. Sauvagos,- however, has employed it in a
t<tvider signitication, so as to include all the other species here
. enumerated ; and perhaps correctly, though CuUen inclines to

GE. II.] NOSOLOGY. 357

C Acida. Of a sour scenti . ,

Ephidrosis acida. Sauv.
y Oiida. Of a rank or fetid scent. Often partial, or eva-
cuated from particular organs, as the feet or axillas :
sometimes from the surface generally, according to
De Monteaux.
Ephidrosis a saburra. Sauv.
3 Moschata. Of a musky scent. Pecklin. lib. ii. obs. 49.
Several of the varieties in sp. 3 and 4 found also
occasionally as symptoms in fevers of various descrip-
tions, exanthems, syncope, porphyra ; and as conse-
quent upon various metallurgical, and other trades.
Suppressed natural secretions of other kinds are also
often combined with the matter of cutaneous perspi-
ration by metastasis, as in suppression of milk, of
urine, of catamenia, and, as has been said, of feces.

GENUS II.

EXANTHESIS.

Simple, cutaneous, rose-coloured efflorescence, in cir^

cumscribed plots, with little or no elevation.

Cutaneous blush.
1. ROSEOLA. Efflorescence in blushing patches, gradually deep-
ening to a rose-colour, mostly circular or oval ; ,
often alternately fading and reviving ; sometimes
with a colourless nucleus : chiefly on the cheeks,
neck, or arras.

Roseola. Severin. Willan.

Rose-Rash.

regnrd the whole of them as merely symptomatic of some other
affection.

Gen-. II. ExANTHEsis. From e|, " ex, extra," and etvSia, " floreo ;"
^mperficial, or cutaneous efflorescence^ in contradistinction to " enan-
thesis," (eva»f4o-«5,) in the present system a genus of CI. III. Ord. III.
importing " efflorescence springing from within^'''' " rash- fever :" whicli
see. The author would have preferred iireiyha-n^ for the mere
reason that it occurs in Aristophanes, t/s ftYiXeiiriy EDHNGEI XNOT2
{In Ntih.) but that at, or £|, is the ^preposition prefixed, and m0^r
applicable, to several of the other genera in this order, and fortps
a better contrast to {», its opposite, than ivt does. " '

358 NOSOLOGY. . fcL. VI.-OR. Ill,

■ Found also, frequently, as a symptom, in* dentition,
djspepsj, various fevers, and other constitutional affec-
tions.

GENUS 111.

EXORMIA.

Small, acuminated elevations of the cuticle ; not containing
a fluid, nor tending to suppuration ; commonly termi-
nating in scurf.

Papula. Cch. Sauv. Linn.

Papulae. JVillan.

Papulous skin.

Common pimples.

Knoten. G.

Boutons. F.

Gen. III. ExoRMiA. ^E^o^f^ix, txfvfcx, " papula," So Galen, " aper-
turn est ab i«,dvitv^ quod esl £|«g(e<«v, id est erumpere, derivatum esse
iKSvf^xTi, id est PAPULis, nomen, in lis quge sponte extuberant in cute."
in lib. iii. Hippocr. § 51. " It is obvious that from iKivuv, synony-
mous with i^o^ftciv, or " to break out," is derived the term ecthyma,
or papula, in those cases in which the eruption takes place on the
skin spontaneously." Ecthyma, however, has from some cause or
other, been generally supposed to import a species of large pus-
tules. It is used expressly in this sense in our own day by Dr.
Willan and Dr. Young; and the author has, therefore, to avoid con-
fusion, appropriated its synonym cxormia or cxormis (£|«g(t*j)) to im-
port an eruption of common papida^ or pimples.

Papula^ indeed, is itself of Greek origin, being derived from
pappus or waTra-oj, "■ the sprouting of down or buds," and hence
*•' the sprouting of the beard." The radical sense is " productiou
or pushing forth ;" for ttxttvx? means lather, and ^aw?r«?, in its
primary signification, grand-lather ; and hence papilla^ another
diminutive from the same stock, imports nipple, the sprouting chan-
nel of maternal nutriment.

'ihe common terminating diminutive via or illn is probably deriv-
ed from the Greek vA» (i(/e or ylc) "materia, niateries," '■'' of the
matter, make, or nature of;"" thus papula or papilla, " of the matter
)V nature of pappus;" lupula, " of the mattt.r, make, or nature of
thi; hipus;" tubula or tubulus, "of the matter, make, or nature of
the tubu« ;" pustula, '• of the nialter, make, or nature of pusf"

GE. III.] 1 KOSOLOGY. 259

1. STROPttULUs. Eruption of red pimples in early infancy,
chiefly about the face, neck, and arms ; sur-
rounded by a reddish halo: or interrupt-
ed by irregular plots of cutaneous blush.
Strophulus. Willan.
Licheniasis Strophulus. Young.
Exanthema Strophulus. Parr.

a, Intertinctus. Pimples bright-red ; distinct, intermixed
with stigmata, and red patches; sometimes spread-
ing over the bodj^
Strophulus intertinctus. Willan.
Rothe. G.

Efflorescence benigne. F.
Red gum. Red gozon.

tubercula or tuberctiliim, " of the matter, make, or nature of the
tuber :" and so of various others. So the Anglo-Saxon kin or kind
(cjnii) is used as a diminutive in the EngUsh lamb-kin, man-akin^
&c. In the cognate dialect of Germany, this last diminutive is em-
ployed still more extensively, for here kind, as a single word, im-
ports child, infant ; family or relative origin ; the first make or
matter of kindred.

Papula and pustula, which by Sauvages are degraded into mere
symptoms of diseases, and not allowed to constitute diseases of
themselves, are raised to the rank of genera by Ceisus, Linneus,
and Sagar, and, under a plural form, to that of orders by Willan.
In the present system exormia and ecphiysis, intended to supply
their place, are employed as collective terms, and run parallel with
those papulae and pustula? of Willan which are not essentially con-
nected with internal disease ; and are only made use of instead of
papula and pustula, first as being more immediately Greek, and
next in order to prevent confusion from the variety of senses as-
signed to the latter terms by different writers. Exormia and ec-
phiysis, therefore, as distinct genera under the present arrangement,
import eruptions of pimples and pustules in their simplest state ;
affecting the cuticle, or at the utmost the superficial integument
alone, and consequently without fever or other internal complaint
as a necessary or essential symptom; although some part or other
of the system may occasiionally sympathise or catenate with the
efflorescence. It is difficult, indeed, to draw a line of separation,
and perhaps impossible to draw it exactly, between efflorescences
strictly cutaneous and strictly constitutional, from the numerous
examples we meet with of the one description combining with or
passing into the other. But this is a difficulty which belongs to
every other branch of physiology, in the widest sense of the term,
as well as to nosologv : and all we ran do. in anv division of the

360 NOSOLOGY. [CL. VI.-OR. III.

C Albidus. Pimples fninute, hard, whitish; surrounded
by a reddish halo. .
Strophulus albidus. Willan.
White gum,
y Confertus. Pimples red, of different sizes ; crowding
or in clusters ; the larger surrounded by a red
halo ; occasionally succeeded by a fresh crop.
Strophulus confertus. Willan.
Tooth rash.
S Volaticus. Pimples deep-red, in circular patches or
clusters ; clusters sometimes solitary on each arm
or cheek ; more generally flying from part to part.
Strophulus volaticus. Willan.
Erythema volaticum. Sauv.
« Candidus. Pimples large,glabrous,shining; of a lighter
hue than the skin : without halo or blush.
Strophulus candidus. Willan.

science, is to lay down the boundary with as much nicety and cau-
tion as possible, and to correct it, as corrections may afterwards be
called for. Dr. Willan's plaji, which is merely monogrammic, or
confined to a single division of diseases, enabled him to unite dis-
orders which have often very little connexion with each other, as
exanthematous fevers, with local diseases of the skin ; small-pox,
for example, with itch, which comes next to it, from the mere cir-
cumstance that both exhibit efflorescences of some kind or other.
But this is a plan which, without entering into its merit, could not
be followed in any system attempted, like the present, upon a
physiological basis, and taking for its range the whole catalogue of
diseases which flesh is heir to. It is on this account that variola
and elephantiasis, by Willan introduced under pustula, and tuber-
culum, are necessarily in the present arrangement removed to
other divisions of the system ; for while Willan employs the terms
pustulae and tubcrcula in the double sense of pustules or tubercles
•with essential affection of the constitution, and wilhout such essential
affection^ ecphlysis and ecphyma are here limited to the last.

Generally speaking, therefore, the species arranged under the
present order will be found simple cutaneous diseases, and in their
purest state perhaps always so. There are, however, as already
hinted at, certain idiosyncrasies, or occasional conditions of the con-
stitution, by which they are more readily i)roduccd, or with which
they more readily associate ; such especially as a lax state of the
fibres, a languid circulation, a general irritation of the system,
whether habitual or the result of accidental debility, or some pecu-
liar affection of the head, stomach, or other organ ; and hence we
occasionally meet with a few varieties or modifications of several

GE. III.] ' NOSOLOGY. 36 1

2. LICHEN. Eruption diffuse ; pimples red -, troublesome sense
•s' of tingling or pricking.
Lichen. Willan.
Zitterich. G.

« Simplex. General irritation, sometimes a few febrile
symptoms at the commencement ; tingling aggra-
vated during the night ; pimples scattered over the
body ; fade and desquammate in about a week.
Lichen simplex. Willan.
C Pilaris. Pimples limited to the roots of the hair ;
desquammate after ten days : often alternating
with complaints of the head or stomach. " Only
a modification of the foregoing." Will.
Lichen pilaris. Willan.

species of cutaneous affection, in which the system at large, or
particular parts of it, appear to catenate with the disease, either
antecedently, progressively, or alternately. This is sometimes the
case with strophulus, and, indeed, with all the species of exormia
or papulag; which, nevertheless, more generally exhibit themselves,
and even under their severest modifications, without any apparent
constitutional affection whatever; of which the prickly heat^ or
lichenose exormia of the West Indies, may be adduced as a striking
example. Lepra or lepriasis is regarded as a constitutional malady
by many writers of recent times; but it was not so regarded either
l^ the Greek or Arabian physicians who duly distinguished it from
elephantiasis; nor is it so regarded by Dr. Willan, who ascribes it
chiefly to cold, moisture, and the accumulation of sordes on the
skin, especially in persons of a slow pulse, languid circulation, and
a harsh, dry, and impermeable cuticle. See his Ord. If. p. 119,
120, 123. — These observations will apply equally to the pustular
and vesicular eruptions ; which are strictly cutaneous in their pure
or simple state, though in a few varieties complicated, from pecu-
liarity of temperament or other cause, with some internal affec-
tion.

Similar to this was the opinion of Mr. John Hunter, not only in
regard to these cutaneous diseases, but to various affections of the
surface of internal canals, of a character decidedly inflammatory,
and making a near approach to erysipelas. " This affection," says
he, " appears to support itself by continued sympathy, for it com-
monly begins at a point, and spreads while it shall be getting well,
where it first began. This cannot be merely constitutional, for if
it was, the part already inflamed could not recover, if i(s increase
in new parts arose from the constitution; but it gives the idea that
when the parts have once gone through this action they lose the
disposition, and become healthy. This property is not peculiar to
40

362 NOSOLOGY. [CL. VI.-OR. 111.

y Circumscriptus. Pimples in clusters or patches of
irregular forms, appearing in succession over the
trunk and limbs ; sometimes coalescing : occa-
sionally reviving in successive crops, and perse-
vering for six or eight weeks.

Lichen circumscriptus. Willan,
0 Lividus. Pimples dark-red or livid ; chiefly scattered
over the extremities; desquammation at uncertain
periods, succeeded by fresh crops, often persever-
ing for several months.

Lichen lividus. Willan.
£ Tropicus. Pimples bright-red, size of a small pin's
head ; heat, itching, and pricking as of needles ;
sometimes suddenly disappearing, and producing
sickness or other internal affection ; relieved by
the return of a fresh crop.

Attacks new settlers in the West Indies, and
other warm regions, and leaves them in a few
weeks when inured to the climate.

Eczesma. Auct. Grcec. See Aet, Tetrab. iv. i. 128.

Essera. Plouquet.

Sudamina. Auct. Lat.

Lichen tropicus. Willan.

Eshera, {Arab.) commonly but improperly written
essera. It is the plural of sheri, papula, but pecu-
liarly applied to this variety.

Rootvont. Belg.

Flacherothe flecke. G.

Prickly heat.

Summer-rash. Cleghorn.

this inflammation ; the ring-worm has this pecuHarity, as also many
cutaneous ulcers. — There appear to be two ways of accounting
for this, one is, that the whole skin is very susceptible of such
action, and readily goes on with it by continued sympathy ; the
other is, that the inflammation is such as to contaminate while it
spreads, but when it has once acted it is cured, as above observed.
If this last be a true solution, then the right practice would be to
stop its progress by destroying the parts beyond it.'' On Blood, p.
271. This practice is in fact often pursued, and with success, in
porrigo or tinea, by a local application of a solution of lunar caustic.
1. Exanthesis Lichen. In the definition of the complaint the au-
thor has adhered as closely to Willan as he has been able ; but he
has been compelled to omit two of Willan's characters, that of the

HE. lll.j . K080L0GY. 363

^ Ferus. Pimples in clufjlers or patches, surrounded
with a red halo ; the cuticle growing gradually
harsh, thickened and chappy ; ofteti preceded by
general irritation.
Lichen agrius (ieyg<«s,/cn<s.) Aucf, Grac.
Papula agria. Cels.
Lichen agrius. Willan.

According to Paulus, ^Egineta, and Orobasius, only
a more violent and inveterote form of «.
« Urticosus. Pimples very minute, slightly elevated,
reddish; intolerably itching, especially at night;
■ irregularly subsiding, and re-appearing ; chiefly
spotting the limbs; occasionally spreading over the
body, with gnat-bite-shaped wheals : from the vio-
lence of the irritation, at times, accompanied with
vesicles or blisters, and succeeded by an extensive
exfoliation of the cuticle.
Lichen urticatus. Bateman. Q ?
J^ettle-licheyi.
3. PRURIGO. Eruption diffuse ; pimples nearly of the colour of
the cuticle ; when abraded by scratching, ooz-
ing a fluid that concretes into minute black
scabs ; intolerable itching, increased by sudden
exposure to heat.
Prurigo. Willan.
Iklet.— Kejik. Turc.

cc Mitis, Pimples soft and smooth; itching, at times
subsiding ; chiefly common to the young, and in
spring time; easily yields to a course of warm ab-
lutions.

disease " affecting adults," and its being " connected with internal
disorder." They are copied by Dr. Bateman, but are at variance
with the species enumerated under the genus ; for the livid lichen
(here marked S) is expressly stated by Dr. Willan, p. 50, to be
common to " young persons and even children ;" and the nettle-
lichen (here marked ^) is described by Dr. Bateman, p. 14, as
^'■peculiar to children," commencing "■in some cases soon after
birth, and sometimes later ;" while the former observes, p. 39,
that the simple lichen (a.) " sometimes appears suddenly without
any manifest disorder of the constitution ;" and states with respect
to the tropical lichen (e) from VVinterbottom, Hillary; Clark, and
Cleghorn, that " it is considered as salutary ;" as " a proof that the
person affected with it is in a good state of health," p. 55 ; fbat " it

3G4 NOSOLOGY. [CL. Vh-OK. III.

Prurigo mitis. WiUan»
C Forraicans. Pimples varying fr6tn larger to more
obscure than in the last ; itching incessant, and ac-
companied with a sense of pricking, or stinging, or
of the cree|)ing of ants over the body ; duration
from two months to two or three years, with occa-
sional but short intermissions ; chiefly common to
adults.
Prurigo formicans. Willan.
y Senilis. Pimples mostly larger than in either of the
above ; sometimes indistinct, giving the surface a
shining and granulated appearance ; itching inces-
sant ; common to advanced years, and nearly in-
veterate.
Prurigo senilis. Willan,

Most intractable in elderly persons v/ho have been
addicted to spirituous drinks, whether ale, wine, or
alkohol ; and hence called by Darwin psora ehrio-
rum, who believes, but without foundation, that it may
be propagated from one part of the body to another
by scratching.

Var. a occasionally terminates in contagious sca-
bies ; C in impetigo ; y in malis pedieuli.
4. MILIUM. Pimples very minute ; tubercular ; confined to the
face ; distinct ; milk-white ; hard ; glabrous ; re-
sembling millet-seeds.
Grutum sive milium. Plcnck,
Gries. G.

seldom causes any sickness or disorder, except the troublesome
itching and pricking," p. 59 ; that " it is not attended with anj
febrile commotion, whilst it continues out," p. 61 ; and that it " is
looked upon as a sign of health ; and, indeed, while it continues
fresh on the skin no inconveniency arises from it, except a frequent
itching." — The subdivisions of Dr. Willan are denominated species;
but for the most part they are little more than modifications of each
other, as he candidly admits in one or two instances, and conse-
quently ought rather to be called varieties, as they are in the pre-
sent text.

2. J) E. Lichen urticosus. This variety is described from several
strongly marked cases which have occurred to the author ; and has
a near resemblance to the lichen urticatus of Dr. Bateman. The
varieties, however, are innumerable.

Gen. IV. Lepidosis: from aw/j-iSo?, " squamma." The Greek is
jjreferred to the Latin term, as concurrent with the general rule

GE. IV.] NOSOLOGY. . 365

G E N U S IV.

LEPIDOSIS.

Efflorescence of scales over different parts of the body,
often thickening into crusts.

Lepidosis. Young,

Squammae. Willan.

Scale-skin.

Kuba or Kouba. Arab. The Arabic term is used in a
wide or generic sense by most of the Arabian wri-
ters, and imports scaly eruptions of nearly every
kind, whether dry or accompanied with a purulent or
other fluid. It is peculiarly thus employed by Avi-
cenna and Serapion. Kuba is the plural of ku-
veb : for the Arabians were fond of employing a plu-
ral noun : of which Eshera in the preceding species

adopted in the present system in regard to the names of the classes,
orders, and genera. The subdivisions are for the most part taken
from Dr. Willan : being pityriasis, from 9rirv^«*, furfura, " bran or
scurf;" lepriasis, from Af5rg#5, scaber^ " harsh, scabrous;" psoriasis,
from •4^»>^», scabies (scabies sicca,) " scabid-soale ;" and ichthyiasis,
from tjctvi, " a fish." The arrangement is a little changed from
that of Willan, as pityriasis, the mildest species, is, in Willan. im-
properly placed between psoriasis and ichthyiasis, the two severest
species. In this part of the new arrangement Dr Young has pre-
ceded the author. In Willan these subdivisions take the place of
genera ; here they are introduced as species ; and ought to have
been so in Willan, as they are sufficiently allied to each other for
this purpose ; and as otherwise, Dr. Willan has no species whatever,
and consequently no disease whatever; for as the author has fre-
quently had occasion to observe already, it is the species alone that
constitutes a disease. Dr. Willan has indeed his subsections, but
they are in every instance mere varieties, and are so understood
and denominated by himself. — See his Cutaneous Diseases, Lepra,
p. 106; Psoriasis, p. 161, and Pityriasis, p. 192 : in all which he
passes immediately from genera to varieties, the important link of
species being singularly omitted.

In Lepriasis, the last variety (S) is added from Celsus; and, on
the authority of Dr. Bateman, as well as the accuracy of his dis-
tinction, the author has given it the synonym of " Leprosy of the
Jews.'' It exactly answers, indeed, to the Mosaic account in Levit.
xiii. 3.

366 NOSOJLOGY. [CL. Vl.-OR. III.

has just furnished us with an example. So morbilli
was used instead of morbillus or. morbillo, and we
still continue to say measles, small-pox, (pocks,) aph-
thae, &:c.

The Persian synonym of kuba is perjun : which,
like the former, is applied also to impetigo or run-
ning tetter.
1. Pityriasis. Patches of fine branny scales, exfoliating with-
out cuticular tenderness.
Pityriasis. Ahx. Trail. Paul. Mgin. Willan.
Lepidosis Pityriasis. Young.
Schuppen. G,
Dandriff.

ti Capitis. Scales minute and delicate ; confined to the
head ; easily separable. Chiefly common to in-
fancy, and advanced years.
Pityriasis capitis. Willan,
Hauptschuppen. G.
C Rubra. Scaliness common to the body generally;
preceded by redness, roughness, and scurfiness of
the surface.
Pityriasis rubra. Willan.
y Versicolor. Scaliness in diffuse maps of irregular
outline and divers coloui*s, chiefly brown and yel-
low ; for the most part confined to the trunk.
Pityriasis versicolor. Willan.

In the Amoenitates Academicce^ Vol. VIII. art. 167, is a Dissertation
of Dr. Westring, in which he strongly recommends the decoction of
the ledum palu.itre for the cure of leprosy, as well as of various
other cutaneous efflorescences, which, as already observed, the
Linneao school ascribed, in almost every instance, to animalcules.
Id Kamtschatka this plant has long been employed for the same
purpose, and apparently with a success superior to that of the
solanum dulcamara. Odhelius, in the Stockholm Transactions for
1774, speaks in equal terms of the same plant; and gives us the
following form for using it. Infuse four ounces of the ledum in a
quart of hot water; strain it off when cold ; and let the patient
drink from half a pint to a quart of it daily-

The Indian name for leprosy is Kush''ta, and it is a frequent com-
])Iaint, especially in Mysore. Among the Barbary states the use of
oil arganic as a iish sauce, and which is supposed to be of a heating
quality, is regarded as a very common cause of leprosy, (merd
jeddam) as it is here still vulgarly called, and particularly in the
niovince of Haha, where this kind of sauce is in great repute.

GE. IV.] _ NOSOtOGY. 36?

2. Lepriasis.* Patches of smooth, laminatedscales of different
sizes, and a circular form.
Vitiligo. Ceh,
Lepra. Willan. Young.
Lepra Graecorum. Auct. Var.

Beras.— Boak. Arah» Both terms are applied to all
the varieties of lepra by most of the Arabian physi-
cians ; but the first should, in strictness of language,
be confined to lepra alhida ; for it usually implies
whiteness, or splendour. It is hence employed to
signify white spots in cattle ; while beresa or bersa
imports, according to Golius, " splendens albicante
cute serpens :" Boak, in its radical idea, denotes ve-
hemence and violence : it is often rendered " ingens
fluxus," " fragor," and applied to a storm.
Aussatz. Gf»
Leprosie. F.
Leprosy.

« Vulgaris. Scales glabrous; whitish ; size of a crown-
piece ; preceded by smaller, reddish, and glossy
elevations of the skin, encircled by a dry, red, and
slightly elevated border ; often confluent 5 some-
times covering the whole of the body except the
face.
Lepra vulgaris. Willan.
Common Leprosy.

5 Albida. Scales whitish ; size of a silver penny ; de-
pressed in the middle ; chiefly confined to the ex-
tremities.
Alphos («x^os.) Aiict. Grcec, Cels.
Lepra alphoides. Willan.
Beras bejaz : Arab, and sometimes bejaz or white
alone, synonymous 'y with alphos.

The lepers of Haha are seen in parties of ten or twenty together,
and approach travellers to beg charity. In Morocco they are con-
fined to a separate quarter, or banished to the outside of the walls :
they are in general, however, but little disfigured by the disease
except in the loss of the eye-brows, which the females endeavour
to supply by the use of alkahol or lead ore, while they give an ad-
ditional colour to their complexion by the assistance of al akken or
rouge. Preparations of arsenic are mostly relied upon for a cure in
the east, and seem to have been chiefly employed with ndrantage
in our own country.

368 NOSOLOGY. [CL. vi.-OR, III.

Weisse-aussatz. G. "

White Leprosy.
y Nigricans. Scales fivid : size of a half-crown piece;
diffused over the body, but less widely than «.
Melas (fuXas.) Auct. Grcec, Cels,
Lepra nigricans. Willan,
Beras asved, Arab.
Swarze aussatz. G.
Black Leprosy.
S Canescens. Scales white ; hairs on the patches white
or hoary ; central depression deep ; disease more
inveterate.
Leuce (Ae««;j.) Auct. Grcsc. Cels.
Leprosy of the Jews. Hensler, Von Abendlandischen
Aussatz, p. 341. Bateman, p. 299.

Several of the varieties found also occasionally,
as a symptom or sequel, in lues ; but distinguished
by a livid or chocolate hue.

See Galeoti^ Dissertazione sopra le malattie che
si curano nel Regio Spedale di Sancto Eusebio.
Firenze, 1771.
3. Psoriasis. Patches of rough, amorphous scales ; continu-
ous, or of indeterminate outline ; skin often
chappy.
Lepidosis Psoriasis. Young.
Psoriasis. Willan.
Impetigo. Sennert. Plenck et Alior.
Scabies sicca. Etmull. Hoffm, Plater.
Hasef. Arab, Sauvages, Vol. I. p. 1 36, has confound-
ed this with asef, or eczema. The hasef of Avicen-
na is the present species ; and is directly translated
scabies sicca by Meninski and Golius.
Kleinaussatz. G.

Scaly Tetter. — Dry Scale. See Levit. xiii. 31 — 37.
« Guttata. Drop-like, but with irregular margin. In
children contagious.
Psoriasis guttata. Willan.
C Gyrata. Scaly patches in serpentine or tortuous

4. Lepidosis Ichthyiasis. The indurated incrustation exhibited in
this disease is produced by a change in the papillae of the cutis ;
which are elongated and enlarged into roundish cones or tubercles,
often void of sensation. The skin has, in some cases, been found
thickened into a stout, tough leather. In a singular enlargement of

GE. IV.] ^1 NOSOLOGY. 369

- stripes. Found chiefly on the back, sometimes on
the face. . .

Psoriasis gyrata. Wiilan,
■ y Dilfusa. Patches diffuse, with a rugged, chapped,
irritable surface ; sense of burning and itching
When warm ; skin gradually thickened and fur-
rowed, with a powdery scurf in the fissures ; ex-
tends oyer the face and scalp.
Psoriasis diffusa. Wiilan.

Sometimes preceded by some constitutional af-
fection.

When limited to the back of the hand it forms
what is vulgarly called the Baker^s Itch. On the
hands and arms, sometimes on the face and neck, is
peculiarly troublesome to washerwomen : probably
from the irritation of the ^oap they are continually
making use of.
,3 Inveterata. Patches continuous over the whole sur-
face ; readily falling oft' and reproducible, with
painful, diffuse excoriations ; extend to the nails
and toes, which become convex and thickened.
Found chiefly in old persons.
Psoriasis inveterata. Wiilan.
■s Localis. Stationary; and limited to particular or-
gans : as the lips, eye-lids, prepuce, scrotum, and
inside of the hands.

In the last form peculiarly common to shoe
makers, and artificers in metallic trades, as bra-
ziers, tinmen, and silversmiths : probably from
filth, and the irritation of the substances they make
use of.

Several of the varieties are found also occasion-
ally as symptoms or sequels of lues, particularly
the first three: but are in every instance distin-
guished by the livid or chocolate hue of the scales.
A. IcHTHYiAsis. Thick, indurated incrustation, encasing the
skin to a greater or less extent : scaliness
imperfect.

the lower extremity produced by a puerperal sparganosis, Mr.
Chevalier found the thickness of the corium in some parts near a
quarter of an iiich ; which, on being cut into, presented the same
grained appearance that is observable in a section of the hides of
the larger quadrupeds. Below the coriaceous skin, the adipose

47 ■ ■ r ^

370 NOSOLOGY. [CL. VI.-OR. lUi

Lepra Ichthyosis. Sauv, .'" ■

Ichthyosis. IVillan.

Lepidosis Ichthyosis. Young,

Fischschuppen-aussatz. G.

Fish- skin.

tc Simplex. Forming a harsh, papulated, or warty rind j
hue dusky ; subjacent muscles flexible. Some-
limes covering the whole body, except the head
and face, palms of the hands, and soles of the feet.
Icthyosis simplex. Willan.

In various instances hereditary.

i Cornea. Forming a rigid, horny, imbricated rind ;
hue brown or yellow ; subjacent muscles inflexible.
Sometimes covering the entire body, including the
face and tongue.
Icthyosis cornea. Willan.

y Cornigera. With horn-like, iricurvated sproutings :
sometimes periodically shed and reproduced,
Cornua cutanea. Plenck.

GENUS V.

ECPHLYSIS.

Orbicular elevations of the cuticle containing a watry fluid.
Wasserblattern. G.
Blums.

membrane exhibited an equal increase of substance, and in front of
the tibia was not less than an inch and a half thick. Me.dico-chir.
Trans. Vol. II. p. 63.

4. y L. Ichthyiasis Cornigera. The Phil. Trans, give various
examples, and Willan has copied others of a curious nature. A few
years since a Leicestershire heifer was shown to the author, labour-
ing under the same affection. The whole of the skin was covered
with a thick, dry scurf ; often itching; and, wherever scratched, a
fluid oozed out, which soon hardened, and put forth corneous, re-
curvating excrescences, often divaricating, and assuming sometimes
a leafy, sometimes a hornlike appearance. The back was covered
with them : over the forehead, and below Ibc dew-lap, they hun^
ia great abundance ; many as hirge as natural horns. The animal

eE. v.] -V NOSOLOGY. 371

1. PompholVx. 'Eruption of blebs containing a reddish, trans-
parent fluid; mostly distinct; breaking and
healing without scale or crust.
Pompholyx. Willan.
Ahenje. Arab.
Wassenblasen. G.

« Benignus. Blebs pea-sized or filbert-sized ; appear-
ing successively on various parts of the body ;
bursting in three or four days, cind healing readily.

was otherwise in good health. A drawing and description was
presented by the author to the Royal Society.

See also Raller^ Elem. Physiol. V. p. 30. Journal de Med. et
Ilistoire de la C/iirurgie., passim.

Gen. V. EcPHLYSis. 'Ex<pAyo-<j, from jx^Av(^<w, " ebullio," " ef-
ferveo," "to boil or bubble up or over:" importing "vesicular
eruption confined in its action to the surface,'" as emphlysis is
" vesicular eruption essentially connected with internal and febrile
affection :" for which see CI. III. Ord. III. H^ematica, Exanthe-
MATicA. The term is intended to include all those utricles or
minute bladders of the cuticle containing a watry fluid, and not ne-
cessarily connected with internal disease, whether buUce or vesicula;^
between which Dr. Willan has made but little difierence in his
definitions, except in respect to size ; and which were equally
denominated by the Greeks phlyctsnas {fXvKTonvxi,) derived from
the same source. And hence the species that fairly appertain to
this genus appear to be pompholyx {'>rcfA<poXv%,) " l)ulia,'' whence
r6fA(poXv'yva^ in bullas converto,, as used by Dioscorides, lib. v. cap.
75 : herpes., from lgT«, " serpo, repo ;" rhypia., from §««•«?, " sordes,"
entirely copied from Or. Bateman; and eczema (eie^s^os,) from ix-^w,
" efferveo.'' In Dr. Bateman, rhypia is written rupia ; but this is
not quite correct : the p is aspirated and the Greek v is almost
always expressed by a Roman y. So Pliny, from the very same root,
writes rhyparographus, (pyT«g«yg«^05,) " a painter of low, sordid,
contemptible subjects :" hence, too, rhythm^ from fviftos ; paralysis,
iVom 7rx^()i?vv(7ii ; and in Dr. Bateman himself, sycosis, from avicov.

2. (b Ecphiysis Herpes Exedens. This variety of herpes appears
to have been much misunderstood, and (o have been held of a far
severer character than it really possesses, in consequence of an
error that has long since crept into the text of Celsus, and been
propagated in the common editions. In his list of ulcers Celsus in-
troduces one called by the Greeks ^n^tcana, vv'hich he describes as
being of a Uvid or black hue, with a fetid smell, and copious dis-
charge, insensible to the touch, thous:h disturbed by itching, with
pain and inflammation around it. And he then adds, according to
the common editions, " fitque ex his ulcus quod 5g7r«r« tyfiiofuve*
Grajci vocant.'' From these proceeds the ulcer, which the Greek*!

372 IVOSOLOGY. [CL,,VI.-OR. HI-

Pompholyx benignus. Willan, -*".

J^ater-blebs,
Z Diutinus. Blebs gradually growing from small vesi-
cles to the size of walnuts ; yellowish ; often spread-
ing in succession over the whole body, and interior
of the mouth ; occasionally reproduced, and form-
ing an excoriated surface with ulcerations. Often
preceded by languor or other general indisposition
for several weeks. Duration Irom two to four or
five months.
Pompholyx diutinus. Willan.
y Quotidianus. Blebs with a dark red base, appearing
at night and disappearing in the morning. Found
chiefly on the hands and legs.
Epinyctis. Sauv.

Call " herpes esthiomenos^'^'' or exedens. And thus the herpes, a cu-
taneous vesicular affection, is extravagantly converted, in one of
its species, into ••' a deep spreading ulcer of a cancerous character,"
as Dr. Bateman has justly described it, according to the general
lection, and not being aware of the error of the text. — In the
Variorum edition, Leonardi Targa has correctly restored the pas-
sage, and given us again <p«ye5«;<p«i», " the ulcer called phageda-na,"
instead of ^^■x■^irx ts-^toftDiov^ by which means the whole is rendered
simple and intelHgibJe. " Antea," says the subjoined note upon the
passage, " legcbatur sgxjjra io-ioif^ivov ; in quo nonnulli Celsum accusa-
runt, contendeutes id ulceris genus (pxyi^aivx* a Graecis appellari.
Et sane banc ipsam vocem ego inveni in Codicibus M.SS. ex iisque
earn reposui. In Medico II. lacuna est. Similis lacuna erat in IV
quoque, ubi nunc herpeta esthiomenon scriptum est alia nianu : unde
vulgaris lectio. Infra quoque legebatur herpes^ ut est aha manu in
eodem Cod. IV. Ego ex Codicibus aliis restitui <pa.y^xivx.

For the real nature, therefore, of the peculiar species or variety
of the herpes called esthiomencs or exedens we must turn to some
other writer than Celsus, who makes no mention of it ; and we can-
not turn to a belter than Galen, who has described it explicitly anrf
repeatedly. Herpes, according to Galen, is an eruption of minute
and crowded vesicles of the size of millet-seeds^ excited on the surface
of the skilly filled with an acrid bilious secretion ; and consists of two
species; the one containing in its vesicles a milder and more aque-
ous fluid, called from the size of the vesicles herpes miliaris^ which
merely seem.9 to burn, or corrode; the other containing a thicker
(luid of a hif^her heat and colour,, and so acrid as actually to corrode
the continuity of the sulijacent skin, still creeping along in a ser-
pentine direction, as the term herpes imports, and hence denominat-
ed by Hippocrates herpes esthionuno^.

GE. v.] ;' NOSOLOGY. 373

Pompholygmus Epinjctis. Young.

Vandermonde relates a case in whiclfHlie acces-
sions were reversed ; the blebs appearing in the
morning and disappearing at night. 1756, p. 340.
S Solitarius. Solitary ; but reproductive in an adjoin-
ing part ; the bleb very large, and containing a
teacup-full of lymph. Preceded by tingling; often
accompanied with languor.
Pompholyx solitarius. Willan.
2. Herpes. Eruption of vesicles in small distinct clusters ;
with a red margin ; at first pellucid, afterwards
opake ; accompanied with itching or tingling:
concreting into scabs. Duration from fourteen
to twenty-one days.
Herpes. Sauv. Linn. Cull. Willan..
Cytisma Herpes. Young.
Neshr. Arab.
Zittermahl. G.
Dartre. F,
Tetter.

«. Miliaris. Vesicles millet-sized : pellucid ; clusters
commencing at an indeterminate part of the sur-
face, and progressively strewed over the body;
succeeded by fresh crops.
Herpes miliaris. Hippocr. Sennert, Hoffm. WilL

Rubeol. p. 238.
Herpes phlyctaenodes. Bateman,
« Exedcns. Vesicles hard ; of the size and origin of
the last ; clusters thronged ; fluid dense, yellow, or
reddish; hot, acrid, corroding the subjacent skin
and spreading in serpentine trails.
Herpes esthioraenus. Hippocr. Gal. Sauv.
Herpes exedens. Turn.

The author has put togetker the above description from Viirious
parts of Galen to make it the fuller; chiefly from his book De Tii-
moribus prceter naturam ; his Methodus Medendi, Lib. II.; and hi?
treatise De Arte curativd, Lib. II. The following are the words of
the Latin translators, which are copied rather than the Greek, as
being more easily referable. " Cum biliosus fluor decubuerit cutem
ukerat : qui vero aquosa sanie sanguineve niistus, minus est acer,
magisqiie in tmnorem attoUit partem quam ulcerat ; Iioc quidera Ery-
WPELAS nominatur, alterum Herpes. Humorem vero qui fecit, et

3"4 WOSOLOGV. rCL.\VF.-OK. 111.

■,;,.., Jr;. ["

Dartre rougeanteJfc P* * •'--•, > ■■> ,^

Minks. Northern counties. Q. ? See ' Willan, Ru-
beol. p. 238. Eatcm. ; Herpes, p. 221, note at the
foot of the page. The ulcerative ringworm of Dr.
Bateman, p. 231, of his Practical Synopsis, is proba-
bly a mere modification of this variety.

The reader may consult with advantage upon this

variety the '^ Colkclanea Societatis Medica? Havnien-

sis." Tom. II. pi. 1. As also Block's Mcdicinische

Benierkungen, p. 97.

y Zoster. Vesicles pearl-sized ; the clusters spreading

round the body like a girdle; at times confluent.

Occasionally preceded by general irritation or other

constitutional affection.
Zoster. PUh. Nat. Hist. xxvi. II.
Herpes Zoster. Sauv. Bateman.
Zona. Ritssel.
Zona ignea. Hoffm. Dnriv.
Feucrgiu'tel. G.
Ceinture dartreuse. F.
Shingles.
S Circinatus. Vesicles with a reddish base, uniting iit

rings; the area of the rings slightly discoloured:

often followed l)y fresh crops.
Formica ambulatoria. Ccls. Turntr.
Annulus repens. Dane.
Herpes Serpigo. Sauv.
Hej-pes circinatus. Baleman.
Dartre encroulee. F.
Ring-ivorm.
i Iris. Vesicles uniling in small rings, surrotmdcd by

three concentric rin^^s of different hues; umbo vesi-
cular and prominent. Usually found about the

hands or instep.
Herpes Iris. Baleman.
Iris. Willan : who at first erroneously regarded if

as an exanthem. and called it, in English, Rain-bov

Rash.

color et calor affectionum indicat. Cum autem rursus acer ipse,
alter quidem minus (alls, alter vero magis .si/, sciendum est ex
ncrioro herpctum, csihinmcnon constitiii. Sic eiiim ipsiiin nominavit

iMippocratos. Ab altero vero altenim cui nonnulli post IJippocra-

teni inilutris iiomeu posuerunt, quia miliis similes cmineniias efficit in

, cute. M:lii quidem talis (luor piliiilu niistus videtur ; alter voro

'exact in bills a^ie ; banc bb rem cum corrosionc fit, ipsum cutis con-

«E. v.] r NOSOLOGY. 375

Rain-hQzo Worm. " v4

^ Localis. Seated on a particular organ, , chiefly the
lip and prepuce, and not migratory.
Herpes labialis. H. prasputialis. Batenian.

3. Rhtpia. Eruption of broad, flattish, distinct vesicles; base

slightly inflamed ; fluid sanious ; scabs thin, and
superficial : easily rubbed oft' and reproduced.
Rupia. Bateman.

ec Simplex. Scab flat; livid or blackish.
C l*rominenS' Scab elevated and conical.
y Escharotica. Sanious discharge erosive, producing
gangrenous eschars.

The species and varieties are given on the au-
thority of Dr. Bateman.

4. Eczema. Eruption of minute, aciiminated vesicles, distinct,

but closely crowding on each other, pellucid, or
milky; with troublesome itching or tingling;
terminating in thin scales or scabs; occasional-
ly surrounded by a blushing halo.

Chiefly produced by the heat of the sun ;
and mostly attacking the hands and other parts
that are principally exposed to its rays.

Eczema. Juct. GrcEc. Willan. Bateman.

Cytisma Eczema. Young.

Hidroa. Saxiv. Fog.

Asef, Arab, literally " ira, aestus," as signified by the
French and English synonyms.

Schweis-blattern. G.

Echauboulure. F.

Heat-Eruption.

tinuum semper apprehendente affectfi ; unde ei nomen est. D&
Tumor. § X. — Sola vero quando secernitur [bilis videlicet,) et in
aiiquo membro consistit, herpes vocatur. Siquidem crassa sit secun-
dum suhstantiam., totam exulcerat cutem usque ad carnem suppositam ;
atque hunc affectum Hippocrates nominat herpetem exedentem. Si
verd teniiior fuerit, id quod in superficie est, tantiwi veluti de-urit :
atque hcec specie-^ generis sortitur appellationem, cum slmpliciter et
sine additione herpes vocetur. Nam ex duabus speciebus, quje
quidem nuper dictjc sunt, altera herpes excdcns nominatur, altera vero
miliaris, quoniam in hoc affectu pmstulct. parvce {(pxvxrxtyxt f^tK^at) et
multce per summum cutem similes miliis excitantur. Fit autem herpes
hujusmodi ex bile quidem et ipse, sed minus calida et acri quam sit
prior. De Arte- curatin. Lib. II. — Herpes non semper ulcus est ;
quotiesque cum exulceratione est non ntiqiie servata veteri scde

376 NOSOLOGY. [CL. V4.-0R. III.

ECPYESIS.

Eruption of small pustules, distinct or confluent; hardening
into cruslular plates.

Ecthyma. Hippocr, Gal.
Pustula. Linn. Sag.
Pustulae. Cels. Willan.
Eiterfinnen. G,
Scall. Tetter.
1. Impetigo. Pustules clustering, yellow, itching ; terminating
in a yellow, scaly crust, intersected with
tracks.
Impetigo. Cels^ Will. Batem.
Phlysis Impetigo. Young.
Herez. Jrab.
Running Scall or Tetter.

A Sparsa. Clusters loose; irregularly scattered ; chiefly
over the extremities ; often succeeded by fresh crops,

vicinas partes depascit ; sed sicuti nomen ipsurn indicate ritu serpentis
bestias, relicto priore loco^ transit ad alterurn." Meth. Med. Lib. II.

Gen. VI. EcpYESis. 'ExTt;)3ir<f, from tx.w6»>^ " suppuro." The
term is used in direct contrast to empyesis, Class III. Order III.
which see ; and consequently is intended to describe pustular erup-
tions, simply cutaneous, or not necessarily connected with internal
affection, as contradistinguished from those that essentially result
from an internal cause. The genus therefore embraces the mere
superficial pustules, of Dr. Willan : — a term correctly limited in his
hands to "elevations of the cuticle with an inflamed base contain-
ing pus."

The author has already had occasion to observe in the note on
exormia, a few pages back, that pustula is the mere diminutive of
pus ({Tiiev, Tfvuats,) probably with the Greek »>« (n/c) employed as a
diminutive termination. In consulting Dr. Bateman, upon the pre-
sent division of diseases, Pract. Synops. p. 143, the reader will find
him suggesting, ingeniously enough, that the term is perhaps deriv-
ed from pus and tulit. It is adverse to this suggestion that pus-tula
was originally written pnsula ; and that pusula is still to be found in
Celsus himself according to the Codex Mediceus 1. It is also to be
recollected, that tulit will by no means apply to pap-ula., tnb-ula,
tuherc-ila^ bacc-ula, strophulus., (from <7T§fl(p9?,) '■'• a small curve" or
*' circlet ;" together withjiundrcds of others to which nlc applies
4??^-With the utmost correctness. In puslulvi the t is merely added for
the sake of euphony.

GE. vl] nosology. 377

Impetigo sparsa. Bateman,
i Herpetica. Clusters circular ; crowded with pustules,
intermixed with vesicles ; often with exterior con-
centric rings surrounding the interior area as it
heals ; itching accompanied with heat and smarting.
Chiefly on the hands and wrists.
Impetigo figurata. Batem.
Herpes. Cull.
Phlyctaena. Fog-.
y Erythematica. Pustules scattered, preceded, by ery-
thematic blush and intumescence ; often by febrile
or other constitutional affection. Chiefly in the
face, neck, and chest.
Impetigo erysipelatodes. Batcm.
I Laminosa. Pustules confluent ; chiefly in the extre-
mities ; the aggregate scabs forming a thick, rough,
and rigid casing around the afllected limb, so as to
impede its motion ; a thin ichor exsuding from nu-
merous cracks.
Impetigo scabida. Batem.
t Exedens. The purulent discharge corroding the
skin and cellular membrane. Chiefly on the side
of the chest or trunk.
^ Localis. Confined to a particular part ; mostly the
hands or fingers ;^and produced by external stimu-
lants as sugar or lime.
Grocer''s Itch. Brichlayer^s Itch,
2. PoRRiGo. Pustules straw-coloured ; fluid viscid ; concreting
into scales or yellow scabs.
Porrigo. Cels. Willan. Batem.
Phlysis Porrigo. Young.
Tinea. Sauv, et Auct. Var.
Teigne. F.
Scabby Scall or Tetter.
' oi Crustacea. Pustules commencing on the cheeks or
forehead in patches ; scabs often confluent, covering
the whole face with a continuous incrustation.
Found chiefly in infants during the period of lacta-
tion.

The species under this genus, consisting of impetigo^ from
" impeto,''' to infest^ porrigo, from " porrum," a leek, on account of
its laminated tunics, or from " porrigo," to spread about ; ecthyma,
from iKivw, " erurapo," to break out ; and scakies, from " seabo,"
to scratch — liavc been verv looselv employed, and in verv differei
48

378 NOSOLOGY. [CL. VI.-OR. III.

Crusta lactea. Auct. -oar. Lat.

Achor ('A;64'{.) Auct, Grcec.

Tinea lactea. Sauv.

Porrigo larvalis. Batem.

Milchgrind. G.

Croute de lait. F,

Milky Scall or Tetter.

The German physicians place their chief depen^

dance for a cure on the internal use of conium ma-

culatnm, ledum palustre^ and lapatum acutum in the

form of decoctions. The first is also employed ex-
ternally. See Sfoerck De Cicuta. Stoelleri Beo-

bachtungen, p. 139.
C Galeata. Pustules commencing on the scalp, in dis-
tinct, often distant, patches ; gradually spreading
till the whole head is covered as with a helmet ;
cuticle, below the scabs, red, shining, dotted with
papillous apertures, oozing fresh matter ; roots
of the hair destroyed : contagious. Found chiefly
in children, especially during dentition.

Tinea granulata. Alison.

Tinea ficosa. Astruc. Sauv.

Achores seu scabies capitis. Plenck,

Porrigo scutulata. Batem.

Shirine. Arab.

Kel. Pres. Turc.

Grind. G.

Tete teigneuse. F,

Scalled-Head,

Sometimes a narrow border of hair is left uninjur-
ed. It is then called Ringu-orm of the Scalp.
y Favosa. Pustules common to the head, trunk, and
extremities ; pea-sized ; flattened at the top ; in
clusters, often uniting ; discharge fetid ; scabs honey-
combed, the cells filled with the fluid. Found
both in early and adult age.
Cerion (K«i{/«».) Grcec.

significations, by most writers. They are here limited to the defi-
nite senses assigned them by Dr. Willan ; and, with the exception
of ecthyma, by Celsus, whom Willan has followed. Ecthyma is
not in Celsus, though it occurs in Galen, from whose explanation it
teems probable that we are not quite using it in its proper sense ;
f^r the latter employs it, as already observed, in the signification

GE. VlJ NOSOLOGY. 379^

Favus. Lat.

Tinea favosa. Astruc. Sau-o,

Scabies capitis favosa. Plenck,

Porrigo favosa. Batem,

Honey-comb Scall or Tetter.
3 Lupinosa. Pustules minute in small patches, mostly
commencing on the scalp ; patches terminating in
dry, delving scabs resembling lupine-seeds; the
interstices often covered with a thin, whitish, ex-
foliating incrustation. Found chiefly in early life.

Tinea lupina. Astruc. Sauv.

Scabies capitis. Plenck,

Porrigo lupinosa. Batem.

Rache seche. F.
% Furfuracea. Pustules very minute with little fluid ;
seated on the scalp; terminating in scurfy scales.
Chiefly found in adults.

Tinea furfuracea. Sennert.

Tinea porriginosa. Astruc. Sauv.

Porrigo furfurans. Batem,

Rache farinense. F.
^ Areata. Clusters of very minute pustules seated on
the scalp, in circular plots of baldness, with a brown
or reddish furfuraceous surface.

Alopecia porriginosa. Sauv.

Makes a near approach to the area of Celsus — the

trichosis Area of the present system. The author

has met with numerous instances of this variety ; and

often simultaneously in the same family, as though

contagious.

Several of the varieties found also, occasionally,

as symptoms in lues, and other constitutional affec-
tions.
5. Ecthyma. Pustules large ; distinct ; distant ; sparingly

of papula ; but as it is better to adhere to one import, though it
should not be strictly correct, than to perplex by introducing seve-
ral, the author has not thought proper to deviate from Dr. VVillaa
upon this point.

The old English term for tetter is scall, still preserved in the
compound Scalled-Head. The Saxon original is sceala, which is only
a modiiication of the Latin " scalas," scales. The Bible translators
have properly rendered by this term the Hebrew pf\3 in Levit
xiii. 30— .-37.

380 NOSOtOGY, [CL. VI.-OR. Jfl.

Scattered j seated on a hard, circular, red
base ; terminating in thick, hard, dark-
coloured scabs.
Ecthyma. fVillan. Batem.
Phlysis Ecthyma. Young.

» Vulgare. Base bright-red ; eruption completed with
a single crop. Duration about fourteen days.
Ecthyma vulgare. Batem.
€ Infantile. Base bright-red ; eruption recurrent in
several successive crops, each more extensive than
the preceding. Found chiefly in weakly infants
during the period of lactation. Duration, two or
three months.
Ecthyma infantile. Balem.
y Luridum. Base dark-red ; elevated ; pustules larger,
and more freely scattered, discharging a bloody
or curdly sanies. Found chiefly in advanced age*
Duration several weeks, sometimes months.
Ecthyma luridum. Batem.
Melasma. Plenck. Linn. Vog.

Found often as a sequel in debilitated habits ; or
constitutions broken dawn by severe fevers or exan-
thems.
4. Scabies. Eruption of minute pimples, pustular, vesicular,
papular, intermixed, or alternating ; intolerable
itching; terminating in scabs. Found chiefly
between the fingers orin the flexures of the joints.
Scabies. Cels. Sauv. Vos.. Sas, Willan. Batem,
Psora. Linn. Cull. Parr.
Phlysis Scabies. Young,
Nekeb. Arab.
Kratze. G.
Gale. F.
Itch.

« Papularis. Eruption of miliary, aggregate pimples ;
with a papular, slightly-inflamed base, and vesicu-

4. E. oi. Scabies Papnlaris. In camps and prisons, where the con-
stitution has been debiUtnted by confmed air and innutritious diet,
this variety is sometimes found to assume a malignant character:
the whole surface of the body exhibiting a sordid tesselation of
crusts, excoriations, and broad livid spots, with an indurated base,
accompanied with fever at night, and severe headache. — See Bal-
linger Von den Krankhcitcn einer Armi^e.

GE. VI.] NOSOLOGY. 381

lar apex ; pustules scantily interspersed : lips, when
abraded by scratching, covered with a minute, glo-
bular, brown scab.
Scabies papuliformis. Willan. Batem»
Rank Ilch.
C Vesicularis. Eruption of larger, and more perfect
vesicles filled with a transparent fluid, with an un-
inflamed base ; intermixed with pustules ; at times
coalescing and forming scabby blotches.
Scabies lymphatica, tVillan. Batem.
Watery Itch.
y Purulenta. Eruption of distinct, prominent, yellow
pustules, with a slightly inflamed base ; occasional-
ly coalescing, and forming irregular blotches, with
a hard dry tenacious scab.
Scabies purulenta. Willan. Batem*
Pocky Itch.
S Comph'cata. Eruption complicated of pustular, vesi-
cular, and papular pimples co-existing ; spreading
widely over the body ; occasionally invading the
face ; sometimes confluent and blotchy.
Scabies cachectica. Will. Batem,
Complicated Itch.
s Exotica. Eruption chiefly of rank, numerous pus-
tules, with a hard, inflamed base, rendering the
skin rough and brownish : itching extreme : abra-
sion unlimited from excessive scratching.
Gratelle. F.
Mangy Itch.

Produced hy handling mangy animals. Several of
the varieties found also, occasionally, as sequels upon
severe small-pox or other causes of constitutional debi-
lity.

The Unguentum Jasseri, so celebrated for the cure of this dis-
ease on the continent, consists of equa) parts of sulphate of zinc,
flowers of sulphur, and pulverized laurel-berries mixed into an
unguent with linseed or olive-oil. — See, for its success, Schinucker
Vermischte Chir. Schriften, Band III. p. 169.

Its sudden suppression, and especially after long continuance, has
been occasionally succeeded by severe internal affection of diffe-
rent kinds. In one instance by mania : Wantner''s Journ. de Medi-
cine, Tom. LVI. p. 115.

382 NOSOiiOGY [cL. VI.-OR. Ilf.

GENUS VIL
MALIS.

The cuticle or skin infested with animalcules-. '

Passio bovina. Auct, Far.

Ma lis. Sauv. Sag,

Phihiriasis, Sauv. Vog. Sag.

Epizootia. Plouquet.

Pai'rtsitismus superficiei. Young.

Haut-ii;secLen. G.

Claveiee. F.

Cutaneous Termination.
1. PEDicuLf. Cuticle infested with //ce, depositing their nits of
eggs at the roots of the hair : troublesome itch-
ing-

Gen. VIT. Malis. M«x<j, ft.xXtti<rfA»<;^ " cutaneous vermination,"
chiefly as it exists among cattle. Tlie Greek word is of doubtful
origin. Probably the real root is the Hebrew term IO7D (malit)
"to deposit eggs," as in Jsai. xxxiv. 15. — '-^'e meet with the same
in Chaldee ; while the Chaldee noun ji^JT»tjVo (malit-ita) imports

putredo, " corruption, putrefaction," synonymously with the Hebrew
ip"). In the malis Jicni'i the author has followed the opinion of
Sauvages, which is now indeed the prevailing opinion of physiolo-
gists; and has supposed, not that the acarus scabiei is the immeUate
cause of, or a constant attendant on, scabies; but only, that where-
ever it is to be traced on the human skin, it is in or about the pus-
tules of the scabies, which serve as a nidus to it ; in the same manner
as a diseased liver in sheep serves as a nidus to the fluke or fasciola
hepatica.

Common as this genus of diseases is to man, it is still more so to
animals of perhaps every other class and description, from the
monkey to the tish-tribes, and from these to the lowest worms. All
of them are infested with parasitic and minuter beings on their
skins, shells, or scales, which afford them an asylum, and, for the
most part, supply them with nutriment.

Yet the same affection is slill more common to plants ; ivhich are
not merely infested with parasitic plants, but with parasitic animals
as well. Of the former, the more common are mosses, lichens,
confervas, agarics, and boletuses; though they are not alwiys of
•the cryptogamic or lowest class of plants, for iho ouphorl-ium
Maurilanicum is infested with the aphyteia hydnora, and various

GE. TIlJ NOSOLOGY.. 38^

Phthiriasis. Sauv. Vog. Sc^.
Lausigkeit. G.
Maladie pediculaire. F,
■ Lousiness,
ti P. humani. Infested with the common louse; chiefly
inhabiting the head of uncleanly children, where it
produces a greasy scurf, or other filth ; and some-
times exulceration and porrigo : occasionally mi-
grates over the body.
Phthiriasis pedicularis. Sauv.
Q P. pubis. Infested with the morpio or crab-louse ;
found chiefly on the groins and eye-brows of un-
cleanly men : itching extreme, without exulceration.
Phthiriasis inguinalis. Sauv.
Morpiones. Darw.

The excrement of this animal stains the linen, and
appears like diluted blood,
2. puLicis. Cuticle infested wiih /fas : o^ten penetrating the
cutis with their bristly probocis, and exciting
pungent pain ; eggs deposited on or under the
cuticle.
Flea-bites.
a. P. irritantis. Infested with the common flea, with a
proboscis shorter than the body : eggs deposited on
the roots of the hair and on flannel.
^ P. penetrantis. Infested with the chigoe, or West In-
dian flea, with a proboscis as lon.'j, as the body:
often penetrating deeply into the skin, and lodging

trees with some species of the viscum or missletoe. OJ the nume-
rous insects that haunt and injure plants, the more common are dif-
ferent species of the aphis, cerambi^c, cj'nips, and curculio. The
first genus is vulgarly known by the name of puceron or green-
louse : its species are numerous; ivid some of them are found in
great abundance on green-house vines, and other green-house
plants : many of these secrete, from ppcuiiar glands near the anus,
a whitish slime, and others a sweetish and viscid juice like the
melligo or honey-dew, and often fron» it, with which they smear the
leaves that afford them support. See Class VI. Ord. II. Gen. III.
4. Paruria mellita. Of the cerambyx, a beautiful, and finely varie-
gated, as well as very extensive family, some species diffuse a
musky odour to a considerable distance ; and some, when taken,
utter a kind of shrill cry, produced by the friction of the thorax on
the upper part of the abdomen and shells. The curcuiio or weevil
iu our own country, is perhaps chiefly found on the hazel-tree ; it

584 NOSOLOGY. [CL. VI.-OR. HI.

its eggs under the cuticle, particularly of the feet :
, producing malignant, occasionally fatal, ulcers.
Malis Americana. Sauv.
Chiques. F.
Biccho. Brazil.
Chiggres.

3. ACARi. Cuticle infested with the tick ; itching harassing, of-

ten with smarting pain.
a A. domestici. " Observed on the head in considerable

numbers." Young.
^ A scabiei. Infested with the itch-tick ; burrowing un-
der the cuticle, in or near the pustules or vesicles'
of the scabies, in those affected.
Scabies vermicularis. Sciuv.
Scabies verminosa. Plenck.
y A. autumnalis. Infested with the harvest-hug ; less ii\
size than the common mite ; infliciing its bite in the
autumn, and firmly adhering to the skin : itching
intolerable, succeeded by glossy wheals.
Harvest-Bug-hite.

4. riLARi^. Skin infested with the Guinea-Worm: — winding

and burrowing under the cuticle, for the most
part, of the naked feet of West Indian slaves ;
severe itching ; often succeeded by inflamma-
tion and fever.

Found chiefly in both the Indies, most fre-
<|uently in the morning dew ; often twelve feet

pierces the tender nut when first formed, and drops an egg into the
aperture, which in due time is transformed into the larve or mag-
got we so frequently find in this kernel. The different species of
the cynips, or gall-flj, in piercing the stem, petiole, or leaf of a plant,
to obtain a nidus for their eggs, produce at the same time a pecu-
liar sting or irritation, in consequence of which the part affected
iallames and swells, new vessels are formed, and a fleshy tumour or
excrescence is engendered, which we denominate a gall-nut. Many
of these galls or excrescences are well known to be of great value.
They are chiefly found on different species of the salix, cistus,
glechoma, veronica, hieracium, salvia, and quercus, or oak. In the
last they are most valuable, and of a peculiarly bitter taste, whence
indeed the name of ,f'o//-nuts. Yet they are not always bitter; for
those of the salvia pom?'/cra, so denominated from its excrescences,
are 6f a sweetish agreeable flavour, and in the east are introduced
upon 'the table as a luxury. The bedeguar, or extuberancc, found
-fin. tJie rose-tree, and that on the leaves of the populus nigra.

GE. VII.J NOSOLOGY. 885

long, not larger than a horse hair. It should
be drawn out with great caution, by means of a
piece of silk tied round its head : for if, by be-
ing too much strained, the animal breaks, the
part remaining under the skin will grow with
redoubled vigour, and often occasion a fatal
inflammation.
Malis Dracunculus. Sauv.

Irk Medini. Arab. Avicenn. Literally vermis Medi-
nensis, though usually but incorrectly translated ner-
viis or vena Medinensis.
Colebrilla, Brazil.
Dragonean. Ver de Guinee. H
Guinea- Worm. See Rhazes ad Almans. Tr. VII.
cap. 24.
fe. GDRDii. Skin infested with the hair-worm: chiefly insinu-
ating itself under the cuticle of the back, or limbs
of infants;* producing pricking pains, emacia-
tion, at times, convulsions.
Malis a crinonibus. Etmull. Sativ. Parr.
Commedones. Hoffm,
Morbus pilares. Horstii.
Emphragma sebacea. Young.

Though described by writers of great credit, the na-
ture of the disease is uncertain. By some authors the
contained fibrils seem to be regarded as a preternatural
production of hairs ; but the greater number, and among
the rest Ambrose Pare, decidedly ascribe to them a
living principle. It appears therefore to be a species of
the gordius or hair-worm ; some of which infest other
animals in a like manner ; and especially the cyprinus
alburnus, or bleak, which, at the time, appears to be in
great agony.

(black-poplar,) and tilia Europosa (common lime,) are the produc-
tion of different insects.

Besides these, the coccus, or cochineal insect, is a very trouble-
some little animal in several of its species, especially c. Hesperidu7n^
found in our green-houses, and also abroad. The acarus tellarius i^
still more injurious, particularly among beans (phaseolus,) cowhage
(dolichos,) and Syrian mallow (hibiscus.) The larve is a small mite,
which destroys the leaves of plants by spinning over them a very
delicate web, and thus obstructing the free ingress of light qud air.
49

S66 inosologV. [cl. VI.-OR. III.

GENUS VIII.

ECPHYMA.

Superlicial, permanent, indolent extuberance ; mostly circum-
scribed.

Phjmatosis. Young.
Hautgewachse. G.
Cutaneous Excrescence.

1. Caruncula. Soft, fleshy, often pendulous excrescence of

the common integument. Found over the

surface generally.

Found also, occasionally, as a sequel of

lues, about the arms and sexual organs.
Radefet. Arab.
Fleisch-driise. G, r.

Caroncle. F.
Caruncle.

It derives, in many instances, a particular name from
its shape, or position, asjicus^ when fig or rasin-shaped,
encanthis, when seated on the canthus or angle of the eye.

2. Verruca. Firm, harsh, arid, insensible extuberance of the

common integuments. Found chiefly on the

hands.
Verruca. Auct.
Phymatosis verrucosa. Young,
Shullul. Arab.
Wartze. G.
Verrije. F.
Wart.

» Simplex. Simple and distinct . sessile or pensile.
C Lobosa. Full of lobes and fissures.*
y Confluens. In coalescing clusters.

Gen. VIII. EcPHYMA. 'EK(f>vf^ci^ from uKpu*, " educo, egero," in
contradistinction both to phyma^ " an inflammatory tumour," and
emphyma^ " a tumour without inflammation, originating below the
integuments." See the notes on both in Cl. III. Ord. II. and Cl.
VI. Ord. I. The terms are formed in parallellism with pyesis,
erapy^sis, and ecpy^sis; phlysis, emphlysis, and ecphlysis, together
with various others.

Extuberances, similar to those belonging to this genus, are fre-
quently found in the rinds of fruits, as of apples and oranges; and

GE. VIII.] ' NOSOLOGY. 387

Destroyed in Sweden by the gryllus verrucivorus,
or wart-eating grasshopper, with green wings spotted
with brown. The common people catch it for this
purpose ; and it is said to operate by biting off the
excrescence, and discharging a corrosive liquor on
the wound. Schoeff. Icon. Tab. LXII. fig. 5.

3. Clavus. Roundish, horny, cutaneous extuberance ; with a

central nucleus sensible at its base.

Found chiefly on the toes from the pressure of tight
shoes.

Clavus. AucL
Ecphyma Clavus. Young.
Zekh. Pers.
Hiineraug. G,
Cor des pies. F.
Corn,

Sometimes spontaneous, and gregarious, spreading
x>ver the whole head or body ; sometimes rising to a
considerable height, and assuming a horny appearance.
In which case it makes a near approach to some of the*
species of lepidosis, especially 1. Ichthyiasis cornea and
cornigera.

Our own Phil. Trans, and the Journals of the Foreign
Societies are full of examples.

4. CALLUS. Callous, extuberant thickening of. the cuticle; in-

sensible to the touch.
Found chiefly on the palms of the hands and soles of
the feet as the consequence of hard labour.
Nasur. Arab. Sheghe, Pers,
Swiille. G.
Calus. F,
Callus.

form a peculiar character in some species of melon : none of which
are produced by insects, nor are we acquainted with the immediate
cause.

4. Ecphyma Callus. Among those who accustom themselves to
long journeys over the burning sands of Egypt, some have had
their feet become as indurated with thick callus as an ox's hoof, so
as to bear shoeing with iron ; and in Siam such persons have been
known to walk with their naked feet on red hot iron bars. See
Haller Elem. Phys. torn. v. p. 88.

Produced also by frequent exposure of either hands or feet to hot
water, or to mineral acids. The feet have been rendered so callous
by the use of sulphuric acid as to endure fire without pain : J)es-

3oH \'0SbL<DGT. [CL. VI.-OR. HI.

GENUS IX.

TRICHOSIS.

IVIorbid organization or deficiency of hair.
Haarkrankheiten. G.

1. SETOSA. Hairs of the body thick, rigid, and bristly.

Hystriacis. Plenck,

Thrown off and renewed every autumn : six lines
long, two or three thick, erect : five sons affected as the
father ; Phil. Trans. Vol. V. no. 424. See also Joiirn.
de Med. Mar. 1756. Paulini, Cent. I. obs. 31.

2. Plica. Hairs vascularly thickened ; inextricably harled,

and matted, by the secretion of a glutinous fluid

from their roots: contagious.
Trichoma. Sauv. Sag. Cull.
Plica. Linn. Vog.
Plica Polonica. Starnigeh
Koltek. Polon.
Wischtel-zopff. G.
Plique. F.
Matted-hair. Plaited-hair.

Usually, but not always, appearing in, or confined to,
the hairs of the scalp. In the beard, Eph. Kat. Cur.
Dec, II. ann. viii. 94. Hairs of the cuticle, Id. obs. 71.

landes, Brem. Magaz. I. p. 665. This acid is, hence, commonly em-
ployed by professed fire-walkers.

Gen. IX. Trichosis. T^t^aaii^ '• pilare malum," Acinar, ^ri^t Aixyv.
71x6. cap. vii. Trichiasis is the more common term, but it has often
been used in a somewhat different and more Hmited sense, Athrix
and distrix, sp. 2 and 4, are evidently derived from the same root :
and the first is here employed, instead of alopecia, which is perhaps
the more common term, because we have the authority of Celsus
for asserting that this last imported properly a mere variety of area,
spec. 5 of the present system, under which therefore it will be
found. Alopecia, as to its origin, is derived from aAajrjjl, " vulpes,"
a fox, from this animal being supposed to lose its hair and become
bald sooner than other quadrupeds ; while ophiasis, the second
variety under the same species, is deduced from e<p/?, a serpent; from
the serpentine direction in which the disease trails round the head.
Polyosis, -Tiray^taTiq, spec. 3 is derived from ;r#AMj, " canus," " candi-
^WS," white, lioary.

GE. IX.] A'OSOLOGV. 389

of the pudendum, Id. Dec. I. ann. iii. 220. Paullinu
Cent. I. obs. 77.

Sometimes preceded by hemicrania, or other consti-
tutional affection ; and occasionally a sequel of psoriasis.
In Poland it appears to be endemic.

3. HiRSUTiEs. Growth of hairs in extraneous parts, or super-

fluous growth in parts common.
Hirsuties. Plenck. Linn. Vog. Sag.
Azeb. Arab.
Haarigkeit. G,

The most frequent variety is that of bearded women,

4. DisTkix. Hairs of the scalp weak, slender, and splitting at

their extremities.
Fissura capillorum. Plenck.
Distrix. Vog.
Gespaltete haarc. G.

5. Poliosis. Hairs prematurely grey or hoary.

Poliosis. Auct. Var.
Spilosis Poliosis. Young.
Shejib. Arab.
Graukepf. G.
Grison. F.
Gray-hairs.

6. ATHRix. Decay and fall of the hair.

Alopecia. Sauv. Linn. Vog, Sag.
Gangraena Alopecia. Young.
Daus-saleb. Arab, literally " morbus vulpis."
Chauvete. F.
Baldness.

» Simplex. Hairs of the scalp of a natural hue : gradu-
ally dying at the bulbs, or loosened by relaxation
of the integument.
Defluvium capillorum. Sennert»
Alopecia simplex. Sauv.

Found, often, as a symptom in tabes, phthisis, por"
rigo and impetigo ; and, as a sequel, in fevers of vari-.
ous kinds.
C Calvities. Hair grey or hoary : baldness chiefly on
the crown of the head and confined to it. Mostly
common to advanced age.
Calvities. Vog.
y Barbae. Decay and fall of the beard. Horst.il',,p»
121. Ephem. A'of. Cur. Dec. III. ann. v. vi. obs. 280,

390 NOSOLOGY, [CL. VI.-OR. HI.

7. Area. Patches of baldness without decay or change of co-
lour in the surrounding hair; exposed plots of
the scalp glabrous, white, and shining : some-
times spreading and coalescing, rendering the
baldness extensive.
Area. Celsus. Jonston,
Alopecia areata. Sauv.
Porrigo decalvans. Batem.

» Diffluens. Bald plots of an intermediate figure ; ex-
isting in the beard as well as in the scalp: obsti-
nate of cure. Common to all ages.
Alopecia. Cds, Gal. et Auct, Grac.
C Serpens. Baldness commencing at the occiput, and
winding in a line, not exceeding two fingers breadth,
to each ear, sometimes to the forehead : often ter-
minating spontaneously. Chiefly limited to chil-
dren.
Ophiasis. Cels. GaL et AucL Grtzc.

The characters of these varieties are given almost
literally from Cds. Lib. vi. ch. iv. The disease makes
a near approach to porrigo Area of the present system.
S, DECOLOE. Hair of the head of a preternatural hue.

« Casrulea. Of a blue colour. Ephem, Nat. Cur. Dec. IL

an. iv. Appx. p. 203. An. vi. obs. 226.
C Denigrata. Changed from another hue to a black.
Paullini. Cent. III. obs. 59 : the sequel of a fever.
Borelli^ Cent. III. obs. 2, from exsiccation. — Schenck,
Observ. Med. I. 4, from terror. — Schurig^ Spermatol :
from white to black ; the colour of the beard changed
also.
y Viridis. Of a green colour. Paullin, Cent. I. obs.

93. Bartholin. Hist. Anat.
J Variegeta. Spotted, like the hair of the leopard.
Paullin^ Cent. IV. obs. 67. Ephem. Nat, Cur. Dec.
III. ann. iii. obs. 184.

The hair occasionally grows, and has sometimes
changed its hue after death. Eph. Nat. Cur. passim.

Gen. X. Epichrosis. 'E7«xc««j? " superficies colorata yel macu-
lata," a coloured or spotted surface. Theophr. de Caus. pi. lib. ii. cap.
7. So iirix^»K'» " iii superficie colore," whence tTrix^tafUf, employed
by Plato, " per summaoi coloratus." The genus is new, but it
eeems called for.

Lencasmus {MvK»rfMi,) is the vitiligo of Willan. The term is

GE. X.] NOSOLOGY. 391

GENUS X.

EPICHROSIS.

Simple discolouration of the surface,
Spilosis. Young,
Flecke. G.

1. Leucasmus. White, glabrous, shining, permanent spots, pre-

ceded by white, transitory elevations or tu-
bercles of the same size ; often coalescing,
and creeping in a serpentine direction ; the
superincumbent hairs falling off and never re-
sprouting.
Common to the surface ; but chiefly found about the

face, neck, and ears.

Vitiligo. IVillan, Balem,

2. Spilus. Brown, permanent, circular patch ; solitary; some-

times slightly elevated, and crested with a tuft

of hair.
Spilus. Muct,
Mahl. G.
Tache. F,
Mole.

merely changed to avoid confusion, as Dr. Willan has employed
vitiligo in a sense different from every one who preceded him.
Leucasmus, the direct import of which is dealbatio, " whitening or
covering with white," is derived from Aeuxoj, " albus, candidus," and
expresses with sufficient accuracy the nature of the species. iSpiluSf
from o-jTiAif, " macula," has been long in use. Lenticula^ is more
generally written in modern times lentigo ; it is here given as it
occurs in Celsus ; who also employs ephelis from e^t)A<f, " vitium
faciei solis ustioue ;" but in a sense far more extended, and apply-
ing to affections which have no connexion with sun-burning. It is
here limited to its appropriate signification. Aurigo is the yellow
or orange hue of infants, so frequently occurring shortly after
birth ; and which is occasionally to be met with in later periods of
life ; depending, as Dr. Cullen observes, either on bile, existing
indeed in the blood-vessels, though not immediately excreted into
them, or on a peculiar yellowness of the serum of the blood distinct
from any connexion with bile. In Cullen this disease is referred to
in a note on icterus in the class cachexije, order impetigines, where
icterus is introduced along with syphilis, scorbutus, elephantiasis,

392 NOSOLOGY. [CL. VI.-OR. FIF.

3. Lenticula. Cuticle stigmatised with yellowish-brown dots,

resembling minute lentil seeds ; gregarious ;

often transitory.
Found chiefly on the face, neck, and hands of persons
possessing delicate constitutions, and red hair. When
of a larger size, the Greeks called them phaciae (^aKieu.)
Cels. VI. 5.
Lenticuia, Cels,
Lentigo. Linn, Vog.
EpheUs Lentigo. Sauv.
Nemesh. Arab.
Leberflecke. G.
Taches de rousseur. F,
Freckles.

4. Ephelis. Cuticle tawny by exposure to the sun ; often spot-

ted with dark freckles, confluent or corymbose ;

disappearing in the winter,
Ephelis a sole. Sauv.
Nigredo a sole. Sennert.
Somraersprosse. G.
Hale. F.

and a variety of other frightful and violent maladies, with which it
has no natural or artificial connexion ; and only because his method
allowed of no other place for its reception. Sauvages has rightly
distinguished between this disease as a mere cutaneous affection of
infancy, and proper jaundice : by describing the first in CI. I. Ord. I .
under the name of ephelis lutea ; and the second in CI. X. Ord. VI.
under that of aurigo neophytoriim.

In drupaceous fruits, and especially those of a fine euticle, as
apples, we often meet with spots and discolourations of the same
character as moles and freckles ; the causes of which we do not
always know, though we can sometimes trace them to small punc-
tures in the cutis by birds and insects.

6. Epicrosis Pcecitia. no.'x<A««, a term of Isocrates, from w««<A<?,
" versicolor," " pictus diversis coloribus ;" whence Pcecile, the
Porch or Picture-gallery of the Stoics at Athens. The species is
new to nosological classification as well as the genus under which
it occurs ; but the morbid affection has been long known to physio-
logists ; and it ought to have had a niche in the catalogue of dis-
eases before now.

The different hues of black, copper coloured, olive, and red, by
which different nations are distinguished in different parts of the
world cannot be regarded as diseases. They are as natural to them
as a fair complexion to an European, and only constitute distinct

GE. III.] NosoLoay. 393

Sun-burn. '

5. AuRiGb. Cuticle saffron-coloured, without apparent affec-

tion of the liver or its appendages ; colour dif-
fused over the entire surface ; transient: chiefly
in new-born infants,

Ephelis lutea. Sauv.

Gelbe haut. G,

6. PcEciLiA. Cuticle marbled generally, with alternate plots,

or patches of black and white.
Cutis variegata nativa. Plenck.

Blumenbach gives examples from a Tartar tribe,
whose skin was naturally spotted like the leopard's, De
Generis Humani varictate nativa.

features in the different varieties of the human race. They are,
however, regarded as diseases by Plenck, who has entered them in
his class maculvE, under the generic terms of rubedo cutis (rothe
haut,) nigredo cutis (schwarze haut,) and albor cutis (weisse haut,)
by the last intending, not the inhabitants of Europe or Asia Minor,
but Albinos, or those included under the genus Alphosis, CI. III.
Ord. IV. of the present system.

Some of these natural, and many morbid discolorations have
often been found relieved by cosmetics, as that of Homberg, which
is a dilute solution of oxymuriate of mercury, with a mixture of ox-
gall. Hartmann's cosmetic was a simple distillation of arum root in
water. If the hands be deeply discoloured, they may be whitened
by being exposed to the fumes of sulphur.

In the American states a black has occasionally been known to
have the whole of the colouring pigment absorbed and carried off
during a severe fever, and to arise from his bed transformed into a
white man. See the same subject treated by M. Bose, Pr. de
Mutato per Morbum colore corporis humani, Lips. 1785. Biichner
relates the case of a man Ivho, on the contrary, on recovery from a
severe fever had his face tinged with a black hue ; probably from a
morbid secretion and deposit of a black pigment along with the
rete mucosum of the face. Miscd. 1729, p. 260.

It is to the partial or variegated secretion of the cutaneous pig-
ment that we are indebted for all the deversified and bear.tifui
hues evinced by different kinds of animals and vegetables. It is
this which gives us the fine red or violet that tinges the nose and
hind-quarters of some baboons, and the exquisite silver that whitens
the belly of the dolphin, and other cetaceous fishes. In the toes
and tarsal membrane of ravens and turkies, it is frequently black;
in common hens and peacocks grey ; blue in the titmouse, green in
the water-hen, yellow in the eagle, orange in the stork, and red in
some species of the scolopax. It affords that sprightly intermix-
60

394 NOSOLOGY. [CL. Vl.-OR. III.

Chiefly found among negroes from an irregular secre-
tion or distribution of the pigment which gives the
black hue to their rete mucosum. In Albinos, whether
among blacks or whites, the secretion appears to be en-
tirely suppressed from constitutional debility or other
defect. See Alphosis, CI. 111. ord. iv.

The subjects of this disease are commonly called
spotted or pyc-halhd negroes.

Plenck asserts that he once saw a man with a green
face, the right side of the body black, and the left yel-
low, produced by previous disease.

' — ...^..— ^-^

ture of colour which besprinkles the skin of the frog and salaman-
der. But it is for the gay and glittering scales of fishes, the splen-
did metallic shells of beetles, the gaudy eye-spots that bedrop the
wings of the butterfly, and the infinitely diversified hues of the
flower-garden, that nature reserves the utmost force of this wonder-
ful pigment, and sports with it in her happiest caprices.

CLASS VII.*
TYCHICA.

FORTUITOUS LESIONS OR DEFORMITIES.

ORDER I.

APALOTICA.

AFFECTING THE SOFT PARTS.

The organization of the soft parts injured or interrupted by
violent assault or exeition.

GENUS I.

TRESIS.

Forcible solution of continuity in a soft part, commencing
externally.

Class VII. Tychica. Ty;^.««, " fortuita ;" " quae forte accidunt •.■"
from Tt/;tii» " eventus, seu casus fortuitus :" th. TvyptJ*'*-

Ord. I. Apalotica. 'A?r«A»T«t(», from «T«eA«T«f, "• mollities, teneri-
tudo." Its opposite is oregeoTwa, from irTe§6«T«5, " tirmitas, duritas,
rigiditas, soliditas:" and hence this has been taken as denominative
of the ensuing order. Possibly malactica and sclerotica might have
been selected if they had been at liberty. But the first has been
long since laid hold of in the materia medica to signify emollients;
and the second in surgery to characterize the outermost or hardest

* [In the '■^ Study of Medicine,'''' thn 7th Class is not noticed at all. No doiiht
because the Diseases included under it do not fall to the care of the physicians. |

396 NOSOLOGY. [CL. VII.-OR. I.

Dialysis. Parr.
1. Vl'lnus. The substance of a soft part cloven ; with a spread
or gaping mouth.
Vuliius. Smiv. Linn, Sag*
Yara. Arab.
Wunde. G,
Blessure. F.
Wonnd,

% Simplex. Simple disunion by a smooth and sharp in-
strument.

Vulnus simplex. Sauv. Young.

Playe simple. F.

Cut.
S Laceratum. The divided substance irregularly torn.

Laceratura. Linn»

Vulnus laceratum. Young.

Lacerated Wound.
y Penetrans. The wound communicating with a cavity.

Vulnus penetrans. Young.

Penetrating Wound.
3 Contusum. The wound eftected by an obtuse instru-
ment, as a ball or splinter, and accompanied with
contusion of the surrounding parts.

Vulnus scloppetorum. Sauv.

Sclopetoplaga. Sag.

Vulnus contusum. Young.

Coup d'ai'ine a feu. F.

tunic of the eye, the sclerotis, or tunica sclerotica ; and it is a use-
ful Linnean rule, well adapted to prevent confusion, not to employ
a term in any branch of the same science in a new sense that has
already been appropriated to a different. Either set, however, will
answer equally well, and can plead equal authority for their use,
though the latter is more common to the medical vocabulary.

Gen. I. Trrsis. T^jxr*?, " plaga ;" " solutio continui ,•" perfora-
tio :" from rnfxu^ " perforo," " terebro." Dialysis, as employed in
a similar sense by Dr. Parr, might perhaps have been used on the
present occasion, but that it has been generally applied by other no-
sologists to disunions of hard as well as of soft parts, and might
hence prove a source of perplexity.

1. 7Vesw Ftdnm. The author has preferred the limited sense of
vulnus as given by the earlier nosologists, to the looser and more
general signification of many writers of the present day, who in-
clude puncture under the term ; and some of whom include excoria-
tion. The definitions, it is hoped, are sufficiently precise to mark

GE. I.] NOSOLOGY. 397

Gun-shot Wound.
Splintery Wound.
2. PuNCTURA. The substance of a soft part perforated ; with
a minute, impervious mouth.
Punctura. Sauv. Sag.
Nish. Of Persian origin.
Stick. G.
Piquure. F.
Punctured Wound. Bell.
Puncture.

M Simplex. Simple disunion by a sharp piercing in-
strument.
Prick.
S Incuspidata. The point of the instrument broken off,
and remaining in the course of the puncture.
Punctura a cuspidi fracta. Sauv.
Echarde. F. Tissot. Avis au Peupie,
Splinter^ needle, or thorn in the^Jfesh,
y Venenata. The pointed instrument loaded with an
acrid or poisonous material ; as the arrows of bar-
barians, with the lama or vicunas ; the fang of the
tarantula and several other spiders; the sting of
the wasp, hornet, or scorpion.
Punctura venenata. Sauv.
Insekten-stick. G.
Piquure venimeuse. F.
Poisoned Wound. Bell.

the differences. Even in free colloquial language we seldom ven-
ture to call a puncture in the finger a wound, when made by a fine
splinter or broken needle, in which the fragment remains imbedded
in the flesh, without bleeding, and with scarcely a trace where it
entered. Wounds, punctures, excoriations, and burns, however,
have a close natural relation to each other, and ought to be arrang-
ed as so many species under one genus. In very slight cases of
burns, indeed, there is no actual solution of the cuticle, nor even
vesication ; but these are imperfect instances, and scarcely deserve
the name of disease^ or the attention of the chirurgical practitioner.
Causis {icxvaii) is here employed to signify biirn, as cauma has already
been to signify inflammatory^ or burning-fever^ the synochus of Vo-
gel, and Synocha of Sauvages and Cullen. The root of both is
Kxtu, " uro."

2. y T. Punctura Venenata. In Ceylon the leaves of the ophi-
orrhiza Mnngos, and in South America the milky juice of the poly-
gala Senega (snake-root) are said to be specifics against the bite, of

398 NOSOLOGY. [CL. VII.-OR. I.

3. ExcoRiATio. The substance of a soft part abraded at its
surface.

Ecdora. Auct. Gr(Kc.

Excoriatio. Auct. Recentior,

Attritio. Vog.

Erythema Paratrima. Sauv,

Excoriatura. Linn.
■ Ertihash. Arab.

HautschwiJruno;. G.

Ecorchure. F.

Excoriation.

a Simplex. Confined to the skin ; chiefly produced by
friction.
The remedial power of oil of turpentine or spirit of

wine lately proposed as a new discovery, may be found

noticed by Sydenham, 0pp. p. 343, 783, and Camera-

rius, Memorab. Cent. IV. n. 53.

C Complicata. Deeper than the integument, with con-
tusion, or loss of subjacent substance. Chiefly
produced by severe flagellation ; though some-
times accidental. See Pibrac^ M. Ac. Chir. IV.
63; Fahre, 74; Louis, 106.

the coluber J\faja (cobra di capello, or hooded snake,) and the cro-
talus horridus (rattle-snake,) as well as against various other em-
poisoned punctures and lacerations. See Amxnitat. Acad. Vol. II.
art. 21 : Lignum Colubrinum. Resp. /. Jl. Darelius ; and art. 22,
Radix Senega, Resp. J. Kiernander.

Oiandah, from repeated experiments of its efBcacy, recommends
taking internally a mixture of rum and Cayenne pepper. Goeth.
Jlnz. 1790.

In all these cases by far the most effectual remedy seems to be
arsenic, whether in solution or oxyd. An arsenic pill, somewhat
similar to that commonly given in India in cases of elephantiasis, as
already remarked in the note on this disease, is asserted by Dr.
Russell, in his History of Indi;m Serpents, to be employed with
great success in the provinces of the Delta, under the name of the
Tanjore pill, each of which forms a dose, and contains a grain of
white arsenic. Mr. Chevalier, taking advantage oithis hint, strong-
ly enforced, in his lectures, a trial of this active alterative in all
cases of wounds from venomous serpents: and Mr. Ireland, an in-
telligent pupil of his, has since carried Mr. Chcvalicr''s recommen-
dation into execution with wonderful success both in St. Lucie and
Martinique. The [>re[)aration he used was Dr. Fowler''s solution,
in the proportion of two dn-.chms every half hour till vomiting or

GE. II.] NOSOLOGY. 399

4. oAusis. The substance of a soft part chemically disunited
or destroyed ; with vesication or eschar.
Erethema Ambustio. Sauv.
Encausis. ^og. Plouquet.
Combustura. lAnn.
Suzish, of Persian origin.
Verbrennung. G.
Brulure. F.
Burn,

GENUS II.

THLASMA.

Forcible derangement in the structure of a soft part, with-
out disunion of the external integument.
Thlasma. Galen. Dioscor.
\. coNcussio. The part weakened, or interrupted in itj> func-
tion, by sudden concussion, without extrava-
sation of blood.

purging ensued, the last being encouraged by cathartic injections r
but as half an ounce of lime-juice formed a part of every draught,
the arsenic was necessarily decomposed and converted into the state
of white oxyd. See Medico-chir. Trans. Vol. 111. p. 893.

Gen. II. Thlasma. ©Aao-^ta, from dXaa^ "• conquasso," " contun-
do, collido." The term is sufficiently broad to cover all the species
which are here arranged under it. It is taken from Galen, as is
also that which distinguishes the next genus: both which are here
employed in the exact import which Galen assigns to them. Hav-
ing spoken of ulcers, fractures, and spasms, in relation to a solution
of continuity, he adds, " ejusdem genesis sunt et quae Graeci gi)y|M«,
{rhegma) et 6Xx<TfMi., {thlasma^^ dicunt. — HeBC in vasis., musculisque, ex-
violento ictii vel gravi casu, vel alio quopiam valente motu excitata.
Method. Medend. torn. vi. p. 85. The root of rhegma, in Latin "rup-
tio, ruptura," is fVaa>, " frango, rumpo :" and from the above quo-
tation we have a proof that the Greeks applied the term regma te
every species of laceration of the soft parts, not commencing exter-
nally so as to make it a wound, by whatever kind of violence pro-
duced, whether a blow, a fall, or any other adequate cause : in the
same manner as they applied the term thlasma to every species of
conquassation, whether concussion, contusion, or strain, .occurring in

400 NOSOLOGY. [CL. VIl.-OR. I.

Concussio. Auct."- '■■'

IJerkeshet. Arah, '

Schiitteln. G. ■

Concussion. F.

Concus!>ion.

2. coNTusio. The part weakened or disorganised in its vascu-

larity by external compression ; with extrava-
sation of blood, and discolouration of surface.

Contusio. Auct.

Contusura. Linn.

Hers. Arab.

Zirknirschung, G.

Neurtrissure. F.

Contusion. Bruise.

3. STREMMA. The part weakened in its motive power by sud-

den and excessive exertion ; with pain anil

tension.
Distensio. Auct.
Levy. Arab.
Verrenckung. G.
Entorse. F.
'Strain. Wrench.

GENUS III.
RHEGMA.

Violent snapping of a soft internal part into two or more
portions.

like parts, from the same latitude of causes. When the lesion fell
CD a ligament or cartilage, we are informed by Galen in the same
place, that the Greeks called it ccrctrvecffinx^ " avulsio ;" probably
from the injured part being distracted, or pulled out of its proper
site or tone. But it does not seem necessary to continue this minute
distinction.

Strerama, ffT^(fz,fm, " a strain, or wrench," from ffr^KpM, " lorqueo,"
has been long in medical use, and was the colloquial term employ-
ed among the Greeks to express this peculiar injury, as we learn
from Ulpian, Dem. Olynth^ ii. The best Latin synonym is j)erhaps
distensio, but this is of looser meaning, and imports other atTection"
as well as the present.

GE. IV.J. NpSOLOGV. 401

Rhegma {^nyfM.) Galen. Aristot.

Ruptura. Sauv. Linn, Vog. Sag.

Laceratio. Young.

Kesret. Arab. .

Zerzerretes. G.

Rupture. F.

Laceration.

1. LiGAMENTARE. Laccration of a ligament.

Laceratio ligamentaris. Young.

Found also frequently, as an accompanying lesion, in
luxations and strains.
Apospasma {xTFovytaafid.) Auct. GrcEC.

2. MuscuLARE. Laceration of a muscle or its tendon.

Laceratio muscularis. Young.

3. VASCULARE. Laccration of a blood-vessel.

Laceratio vascularis. Young.

4. viscERALE. Laceration of a viscus.

Laceratio visceralis. Young.

GENUS IV.

HERNIA.

Protrusion of an abdominal organ through some intei^-
stice in its proper cavity, producing a soft and slight-
ly elastic tumour.
Cele («nx»).) Auct. Gro&c.

Gen. III. Rhegma. See the preceding note.

Gen. IV. Hernia. 'Egvix : from l^nos, " germen, ramus," shooting
forth, ramification, whence the Latins called it ramex. Hernia,
however, was a name given to the disease by the later Greek
writers as Galen expressly informs us ; for by the earher it was
simply called kkXvi, (cele,) tumour, or swelling. It was necessary, in-
deed, to make a distinction: since from the latitude of sense afibrd-
ed by cele, the term was applied, and still continues to be so, to a
variety of diseases which have no connexion whatever, except that
of a greater or less degree of intumescence: as bydro-cele, sarco-
cele, broncho-cele, encephalo-cele.

Some benefit, therefore, in point of precisioH, was gained by the
introduction of the term z^nm, or ra7ncx, however trivial the term in
51

%

402 NOSOLOGY. [CL. Vtl.-OR. 1.

Hernia. Auct, Lat. Linn. Cull.
Demm. Mrdb. •

Bruck. G. , ■

Hernie. F.
Rupture.
1. iNGUiNALis. Tumour extending from the groin more or less
deeply to the scrotum, or labia on either
side. — Consisting of a portion of intestine or
intestinal tunic, protruded through the re-
spective abdominal ring, enclosed in a peri-
toneal sac.
Hernia inguinalis. Heister. et Alior.
Kervet. Arab.
Inguinal Rupture.

Bubonocele : Auct. when confined to the groin.
Oschiocele. Auct. > when at the bottom of the scro-
Scrotal Rupture, ^ turn.

Occasionally found ossified, Eph. Nat. Cur. Cent. X.
obs. 57.

M Intestinalis. Descent of a portion of intestine alone :
tumour tense, equal, roundish.
Enterocele. Auct.
C Omentalis. Descent of a portion of omentum alone :
tumour soft, compressible, unequal, oblong.
Epiplocele. Auct.
y Duplicata. Descent of some portion of intestine and
omentum.
Entero-epiplocele. Auct.
% Congenita. Sac formed of the tunica vaginalis; tu-
mour in immediate contact with the testicle.

itself. Yet even hernia has been employed by many writers with
too loose an interpretation, and been allowed to run a race almost
as wide as ce/e, though expressly intended to be restrained to a par-
ticular division of the diseases which the older term had been al-
lowed to comprise. And we have hence had hernias of the brain,
of the eye, of the uterus, of the veins ; fleshy, bloody, watry, and
windy hernias, with as much confusion as was ever produced by the
use of cele in its wildest pruriency. Sauvages seems to have been
altogether at a loss what to do with the term ; and has hence en-
tirely dethroned it, and re-estabhshed cele upon its downfall. There
are many writers, however, who have used it in a more limited and
correct sense. Heister perhaps led the way to this greater simpli-
city of import ; and he was soon followed by Linnfeus, who possibly

i
GE. IV.] NOSOLOGY. 103

Hernia congenita. Haller. et Auct. Recentior,
Congenital Rupture.

As this variety must accompany, and consequently
be coeval with, the descent of the testis, it must ne-
cessarily take place only a few weeks before, or at
an early age after, birth.

See Baillie, Morb. Anat. Fasc. IV. PI. 7, 8.

2. FEMORALis. ■ Tumour seated on the upper and anterior part

of the thigh. — Peritoneal sac protruded
through the opening for the transmission of
large blood-vessels.
Hernia femoralis. Auct.
Hernia cruralis. Heister et Alior.
Femoral or Crural Rupture.

Admits of an intestinal, omental, and duplicate vari-
ety, as in the preceding species.

Is sometimes found included in a double sac, the in-
terior of which has occasionally been mistaken for the
intestine, till laid open. See Mr. Chevalier's two cases,
Medico-chir. Trans. Vol. IV. p. 322.

3. UMBiLicALis. Tumour protruded at the navel. Involved in

a peritoneal sac, often blending itself with
the neighbouring parts : contents sometimes
bursting, from magnitude, through sac and
skin.
Hernia umbilicalis. Heist, et Alior.
Umbilical Rupture.

Admits of an intestinal, omenj^, and duplicate varie-
ty, as in the preceding species.

carried his restraint somewhat too far, hernia being with him limit-
ed to a protrusion of the intestinal canal alone : and hence his defi-
nition is as follows : " intestini obtecti ultra propriam sedem protru-
sio." Cullen has unfortunately restored the term to its larger and
looser sense ; and hence in ihe present day it has little or no defi-
nite meaning whatever. Mr. B. Bell has again attempted to give it
a precise import by confining it, not indeed with Linneus, to pro-
lapses of the intestinal canal alone, but to a " protrusion of some
part or parts from the cavity of the abdomen ;" and it is in this mid-
dle sense that hernia is employed in the present system ; being
limited to what Harvey has forcibly called the " abdominal pene-
trails.''''

Hernia is in almost every instance the result of violence oru'tfdue
exertion, either alone, or in conjunction with a local laxity of fibre.

404 • , .xospLCMsy. [cl. tii.-or. i.

S Ventriculi. Protrusion of the stomach into the her-
nial sac, with or without a portion of the Intestinal
materials. '• . ;

. Hernia ventriculi. Haller. et Alior, ■>

Gastrocele. Auct. Var.
, I Hernie de I'estomac. La Faye sur Dionis.
Rupture of the Stomach.
E Hepatis. Protrusion of the liver into the hernial sac,
with or without a portion of the intestinal ma-
terials.
Hernia hepatis. Bossnii et Alior,
Hepatocelc. Auct. Var.
Hernie du foje. Arnaud des Hern.
Rupture of the Liver.
^ Splenis. Protrusion of the spleen into the hernial
sac, with or without a portion of the intestinal ma-
terials.
Hernia lienis. Fahr. Hildan. Epist.
Splenocele. Auct, Alior.
Hernie de la rate. Arnaud. des Hern.
Rupture of the Spleen.
4. VENTRALis. Tumour found indefinitely in the region of the
belly : for the most part adjoining the linea
alba. Peritoneal sac often large, and pro-
truded between the interstices of the abdo-
minal muscles.
Hernia ventralis. Heister. et Alior.
Ventral Rupture.

It belongs therefore obviously to the present class and order. Even
in congenital herniasis it is probable the same causes would be found
to apply if we could trace their commencement ; and this more
especially in those that lake place subsequently, instead of antece-
dently, to birth, and accompany the testicle in its retarded descent
into the scrotum. The English name of rupture is highly improper,
being founded in a misconception that the peritoneal tunic is lacerat-
ed in every instance of the disease, instead of being merely elongat-
ed and protruded as a surrounding sac. It is only in a few cases of
the ventral and umbilical species that an actual rupture has been
found ; and in these instances it has occurred less from the nature
of the disease, than from the weight and magnitude of the protrud-
ing viscus. The French, more correctly, confine the term rupture,
to express the genus rhegma-, which by Latin writers was indeed
yspal.ly denominated ruptura..

GE. ly.}" NOSOLOGY. 405

Varied as in the preceding species, and the varieties
distinguished by the same organic names. Chiefly
found during infancy, or in corpulent habits. — Once in
a woman who had submitted successfully to. the Cesari-
an section. Saviard, Observ. Chirurg.
5. iscHiATicA. Tumour seated on the upper part of the male
perinaeum, or lower pah of the female labia.
Peritoneal saC protruded through the great
foramen of the ischium ; mostly filled with a
portion of intestine.
Hernia foraminis magni ischii. Auct.
Ischiatocele. Vog.
Ischiocele. Sag.

Hernia of the Foramen Ovale. Bell.
S. VESiCALis. Tumour seated in the groin, forepart of the
thigh, or perinaeum : fluctuating. — Formed by
a protrusion of the bladder ; commonly sub-
siding on voiding urine.
Hernia vesicae urinariae Salzmann.
Hernia cystica. Auct. Var.
Cystocele. Platner, Ign. La Chausse. Sauv,
Hemic de la vessie urinaire. Mery. Mem. de VAcad-
Rupture of the Urinary Bladder.
tc Simplex. The naked bladder alone protruding.
6 Complicata. Protruded bladder, accompanied with
a portion of intestine or omentum, surrounded by
the peritoneal tunic.
7. DiAPHRAGMATiCA. Indefinite intumescence, or fullness of the
chest,, with difficulty of breathing, and
. r a sense of weight pressing internally on

the lungs.

Formed by a protrusion of a portion
of intestine into the chest through an
aperture in the diaphragm. May be
produced by violence or ulceration ;
but is more frequently the result of a
misformation of the diaphragm. See
Baillie, Morb. Anat. Fasc. IV. PI. 8, f. 1.

"si-m--: -^

I0t» ''Oology. Tcl. v1^.-or. i

G E N U S V.
ENTHESIS.

Irritation or obstruction of a natural passage by the intro-
duction of an improper material.
Obstructio. Young.

1. OESdPHAGEA. Improper material obtruded into the esophagus.

Obstructio oesophagea. Young.

The more cdmmon substances are hairs ; small fea-
thers ; fish-bones ; fruit-stones ; various pieces of money.

These have often remained fixed for a very long time ;
and have occasionally been found to migrate to very
remote parts. A needle has continued in the esophagus
for nine years before it was loosened and discharged ;
Kehring^ Specil. Anat. obs. 42. A fish-bone, after long
obstruction, worked its way through the substance of
the esophagus, and was at length thrown out at the
cutis ; Arculari, Praclica^ cap. 57. The point of a sword,
for thirty years buried in the eye, was at last ejected
by the palate; Hoechstet(,er,Dec. VI. cas. 9.

The esophagus has sometimes been large chough to
allow a half-crown to pass without injury, which has
been evacuated by the rectum. A half-crown piece of
this kind is in Dr. Hunter's Museum. See also Baillie,
Morb. Anat. Fasc. III. Pi. 1, for several other curious
examples.

2. vENTRicuLARis. Improper material swallowed into the sto-

mach.
Obstructio ventricularis. Young.
tt Mechanica. Hard and indigestible substances ; as a

knife ; a nail ; pieces of money ; a multitude of

fruit-stones.
C Venenata. Poisonous substances, vegetable, mineral,

or chemical.

3. iNTESTiNALis. Improper material lodged in the intestinal

canal.

Gen V. Enthesis. ^'Eitarn, " insititium ;" " a foreign substance
or fragment of a foreign substance introduced into a substance of a
different kind." And hence the term at times imports a graft or
scion. ,

GE. V.]- NOSOLO^y. ^ 407

** Obstructio intestinalis. Young. ^^^:_

Occasionally discharged by an abscess at a distance;
sometimes, when pointed and slender, as pins or nee-
dles, migrating to a remote organ. See. Phil. Trans.
1768-9. Xichols,--hon^. Med. Journ. IV. 77, Btw : VI.
36, Mills: Id. 401, Boys.

4. TRACHEALis. Improper material lapsed or inhaled iajo the

trachea.
Obstructio trachealis. Young.
a Mechanica. Impeding the passage.
C Mephitica. Noxious to the respiration.

5. URETHRALis. Foreign substance broken in the urethra, or

dropped from it into the bladder.

Chiefly fragments of bougies, improperly
manufactured ; or continued to be employed
by the patient after being worn out.

The author was once consulted in a case
in which the operation for lithotomy had
been performed to recover a fragment of a
bougie that had been unskilfully pushed into
the bladder. The operation was in vain,
and the man died. Had the patient been a
female, the proper operation would have
consisted in enlarging the urethra by sponge- •
tents, or some other elastic instrument, so as
to have admitted the fore-finger, or stone-
forceps. See CI. VI. Ord. 11. 4. Lithia,
vesicalis. •

ORDER 11.

STEREOTICA.

AFFECTING THE HARD PARTS.

The continuity or connexion of the hard parts impaired Or
interrupted by violent assault or exertion.

Ord. II. Stere6tic». 'SrificriKtCt from ffn^iorm and crrt^tos, '^ duri-
tas, firmitas," and " durus, firmus." The term is applied to horns
by Aristotle : Kt^xrx «•«§£» ; and in the Odyssey to stones : trrs^ttt X1U9.
See note on Order I. Apalotica.

408 * /^ .^iPSOLOGY. [CL. VII.-OR. II.

GENUS I.
CATAGMA.

Forcible division of a bone into two or more parts.
Catagma. Galen, et Auct. GrcBC.
Clasis. Parr.
1. Fractura. Bone broken ; the divided edges more or less
separated from each other.

Pain ; inipeded function ; where moveable,
a grating sound on motion; where immovea-
' ble, morbid depression or other inequality,

Fractura. Auct.
Mekser. Arab.
Bein-bruch. G.
Fracture. F,
Fracture.

1 Simplex. Bone simply divided, with little injury to
the surrounding parts.
Simple Fracture.

Produced, occasionally, by violent action of the
proper muscles of the bone, without other force —
chiefly by spasmodic action. See Act. Nat. Cur. Vol.
Vll. obs. 127. Leske, Auserl. Abh. Band. III. p. 279,
the shoulder. — Both thigh-bones broken by tetanus,
Despoifies, Hist, des Maladies de St. Domingue, II.
171. — Another case, by convulsions, Eph. Nat. Cur.
Dec. I. ahn. ii. obs. 225. See Clonus, Palpitatio, «.
The ends of a fractured and ununiting thigh-bone,
united by sawing off the tips ; Medico-chir. Trans.
Griffith Rowlands, Vol. II. p. 47.
w Comrainuta. Bone shivered at the divided part.
Fracture avec fracas. F.
Splintery Fracture.

Gen. I. Catagma. Kccrxyf*ity from xxr»v»>> " confringo." So Ga-
len, " In osse fractura, Graecis *«T«y^« dicitur." Meth. Med. Tom.
VI. 85. And this he tells us, shorti)' afterwards, was the colloquial
term, for that it was <ec/irtica//y denominated apagma [ccTFayfiu,) "•Huic
proprium nomen inditum Gra;ce est *«T«y^«, omnibus fere homini-
bus qui Grae,(i loqui norunt, tritum : ccTric^fioc namque medicorum
^^ppellatio propria est, plebi inusitatum." Meth. McJ. Tom. VI. 131.

^^

GE. Il.J.tfv NOSQLpGy.'", * 409

y Denudata. Divided edge of -the bone penetrating
the skin, and laid bare.
Compound Fracture.
^ Complicata. Combined with depression, dislocation,
or other injury.
Complicated Fracture,
2. FissuRA. Bone cracked : the divided edges still in contact.
External violence : the internal derangement more
than correspondent to the external injury.
Selau. Arab.
Schrunden. G»
Felure. F.
Fissure.

Chiefly affecting the cranium, though the long bones
are occasionally subject to it, and especially the ribs.
See Heister, Chir. Tom. I. cap. vi.
m Subjacens. Fissure immediately below the external
injury : morbid symptoms confined to the same re-
gion.
Simple Fissure.
C Contra-jacens Fissure and severest symptoms on
the opposite side of the scull, to the external injury.
Contra-fissura. — Resonitus. Plouquct.
Qounter-fissure.
y Complicata. Combined with a counterstroke produc-
ing concussion or extravasation ; or witi) some asso-
ciate injury on the same side.

See a singular case of Le Dran's, in which the
outer table of the head was fissured ; the inn^^r
had a small bony scale thrown off from it ; an ;
concussion with extravasation took place on the
opposite side of the scull. Ohs. xvii.

GENUS II.

CAMPSIS,

Bone or cartilage forcibly bent from its proper shape with-
out breaking.

Gen. II. Campsis. Kxft^n, " flexio, curvatio, inflexio :" from
xnfAirr^t " ilecto. inflecto, incurvo."
52

410 NOSOLOGY. [CL. VII.-OR. II.

1 . Depressio. Form' of the bone or cartilage flattened or bent
inwards.
Thlasis. Vog.
.'Depressio. Auct. Var.
Depression.

Found chiefly in young subjects; and principally on
the cranium and ensiform cartilage of the chest. Bone
often recovering its proper figure with the gradual
growth'of the frame.

Found also, occasionally, in persons predisposed to
pBTostia Jlexilis, ov softness of bones : which see.

GENUS III.

EXARTHREMA.

Extrusion of a bone from its seat of articulation.
Exarthrema. Auct. Groec. Sauv. Sag.
Luxatura. Linn.
Ankhyla. Arab.
Verrenckung. G.
Luxation, F.
Dislocation.
i. LuxATio. Bone, easily and extensibly moveable, forced
completely from its articulating cavity.
Exarthrema Luxatio simplex. Sauv,
Exarthrema completum. Alior.
Luxatio. Vog.
Luxation complelte. F.
Luxation.

The humerus has been luxated by a fit of convul-
sions, Bilguer, Wahrnehmung. &c. p. 221.

Gen. III. Exarthrema. 'E^ufSf^fiei, " exarticulatio," from tcf9f6ff
" artus." The term is in common use with Hippocrates, Galeii,
and all the Greek writers. Loxarthrus^ by which the third species
is distinguished, is comparatively of modern date ; but it has obtained
general credit, and there is no necessity for disturbing it. It is de-
rived from A<)|«f, " obliquus." and u^$^tf, as above, — " twisted, or
oblique joint."

GE. IV.] ' N0S8OLOGY. . 411

2. SuBLuxATio. Bone, easily and extensively moveable, forced

partially from its cavity ; and resting on the
edge of the socket.
Exarthrema Subluxatio simplex. SaiLv.
Exarthrema incompletum. Alior.
Subluxatio. Vog.
Luxation incomplette. F.
Subluxation.

In the Act. JVat. Cur. Vol. X. obs. 68, in a singular
case of luxation, or subluxation of the vertebrae of the
neck, without serious mischief. - .

3. LoxARTHRus. Bono, slightly and narrowly moveable, forci-

• bly loosened in its articulation, and dis-
torted in its relative position.
Loxarthrus. Sauv. Sag.
Perversio capitis Ossium. Duverney, Tom. ii. cap. ii.

Chiefly occurring in the bones of the chest, with sub-
sequent gibbosity, especially in young persons : and in
the bones of the carpus and tarsus, producing crooked
wrists and splay-feet.

GENUS IV.

DIASTASIS.

Forcible separation of immoveable bones or their appen-
dages from their natural union with each other.
Diastasis. Auct. Grcec. Sauv. Sag,
Ossium recessus. Auct. Lat.
Luxatio Diastasis. Young.
Ecartement des os. F,
Separation of Bones.
1. EPiPHYSicA. Separation of a bone from its epiphysis.
Diastasis epiphysica. Sauv.
Diastasis epiphysium. Duverney, Tom. II. cap. i.

Confined to the stages of infancy and feeble adoles-
cence : for the epiphyses of bones in a healthy constitu-

Gen. IV. Diastasis. Litcmtcffn, " interstitium, intervallum, di-
remptio, distractio in duas partes ;" from ^utrmtti, " separo. dissocio."

412 NOSOLOGY. [cL. vn.-oR. in.

tion become gradually apophyses or constituent parts of
the bones themselves.

Often mistaken by the unskilful for a luxation ;' and
aggravated by vain and painful attempts to effect a re-
duction.

See, on this subject, Heister, Chirurg. Tom. I. 1. iii.
§§13.19.

2. cARTiLAGiNEA. Separation of bones connected by an inter-

vening cartilage.
Diastasis synchondrosica. Sauv.
Diastasis synchondroseon. Fabr. Hildan.
Diastasis. Parr.

Exemplified most commonly in the separation of the
symphysis pubis in cases of preternatural labour : though
other instances are not unfrequent.

Separation of the bones of the pelvis by a violent fall
from a horse, Phil. Trans. Vol. XLIV. Cameron. —
Leske, Auserl. Abhandl. III. 299. — Ileum separated
from the sacrum, Fabr. Hildan. Opp. p. 992.

3. suTORiA. Separation of connecting sutures.

Diastasis raphica. Sauv. .

Recessus suturarum Cranii. Duvemey.

Diachalasis. Vocr.

A separation of the sutures of the scull is usually fa-
tal. Mr. B. Bell mentions one instance of an injury of
this kind that terminated favourably : Surg. Vol. VL ch,
xL sect. ii.

ORDER IIL

MORPHICA.

MONSTROSITIES OF BIRTH.

Deformities anomalously produced during the generation or
growth of the fetus.

Ord. III. MoRPHicA. M«g(p<«oe, " ad formam spectantia :" from
fc»{^i), " forraa."

Most of the genera under this order may find parallels among
plants, which are perpetually affording monstrosities of every kind-

■■' .■ '^

■GE. I.] ' nosologt; . 413

GENUS I.

METROCELIS.

Congenital discolorations on the surface,
Metrocelis. Auct, Var.
Nsevus. Sauv, et Alior.
Khal. Arab. Pers. Bek. Turc.
Muttermahle. G.
Envie. F.
Mother'' s-mark.

1. SPiLOSA. Simple, superficial, circumscribed stain ; for the

most part jellow, brown, or red.
Nasvus flammeus. Plenck.
Feuermahl. G.

a Circularis. With a circular or orbicular outline.
C Foliacea. Leaf-shaped.

y Arachnoides. With slender, claw-shaped, or spider-
legged ramifications.

2. FRUCTiFORMis. Dark-coloured, yielding extuberance ; in the

form of fruit ; with a glabrous or granu-
lated surface.

The fruits chiefly represented are the

cherry, currant, and grape, with a smooth

surface ; and the mulberry, raspberry,

and strawberry, with a palpulous surface.

« Pediculata. Possessing a foot-stalk.

« Sessilis. Fixt to the surface by a broad base.

3. TURGESCENs. Large, loose, sanguine, irregular-shaped tu-

mour ; sensibly composed of a congeries of
bloated and distorted vessels.

Sometimes they occur in the stem, which is contorted, curved, or
otherwise crippled, and particularly in cold climates. Sometimes
the leaves are supernumerary, frizzled, too thick, or discoloured.
Trefoil, for example, occasionally produces four leaves ; and the
beech and other trees occasionally leaves of a permanent red. So
fruits are frequently too large or too small, aggregate, crooked, or
offer twins of various kinds; among the more curious of which is
that of one involving another in its interior, as especially occurs in
the lemon.
Gen. I. Metrocelis. M«Tg«K»jM, " materna macula :" from>«jrr»|»

414* NOSOLOGY. [CL. VIl.-OR. III.

Naevus caveraosus. Pknck, — It also includes the pre-
ceding.

4. DIFFUSA. Discoloration spreading indeterminately over a limb,

or a large part of the body.

Riedlin describes a case of universal discolo-
ration from a fright of the mother, making an
approach to epichrosis Paciliu : Lin. Med. 1696.
p. 110.

5. Cana. Hair of the scalp hoary. Schenck ex Stuckio, Lib.

1, obs. 3.

GENUS II.

OLOPHONIA.

Congenital misconstruction of the vocal organs.

1, NARiuM. Misconstruction of the nostrils.

« Obstruens. Impeding the utterance, from imperfora-
tion or other cause.
Imperforate Nostrils. Youngs p. 414.
Z Defectiva. The organization incomplete.

2, LINGUA. Misconstruction of the tongue or its appendages.

Paraglossa. Vog.

tt Adhesiva. Adhesion to the surrounding parts.

Adhesion of the Tongue. Young, p. 414.
C Fraenata. Tied beneath by contraction of the fra^num,
or its extending too near the tip.

Ancyloglossum. And,

Tongue-lie,

" mater," and *riA«f, " macula." See Mr. Aberoethy's valuable re-
marks for removing many of the worst cases oi this deformity with-
out an operation, by merely confiaing the distended vessels, and di-
minishing the temperature ; illustrated with several successful cases.
Observations^ 1810. p. 224.

NfiBvuB is a more common name for this aflfection than metroce-
lis ; but it is a barbarous term of very doubtful origin.

Gei». II. Olophonia. 'Oa«^«»«, for c>,»o(f>u»ta, " oblaesa vox :" from
•X/w, «AXvw, or oXXvf4i, " perdo, ^ernicium infero, perimo ;" and ^ann,
vox. Crat. in Horis ex Athen. \. ix. The genus is wide, but the
term sufficiently extensive to cover jt.

GE. in.] NOSOLOGY. 415

y Deglutatoria. Fiaenutn loose or absent, and the tip
of the tongue doubling bank upon the fauces.
Paraglosse deglutatoria. Sauv.

For examples, consult Petit's " Observations," con-
taining numerous cases.

3. PALATi. Misconstruction of the palate.

Hyperoum. Mud. Var,

4. LABii. Misconstruction of the lips.

» Lobata. Lip lobed or divided in the middle; edges
separated and convex.
Lagostoma. Auct.
Labium leporinum. Sauv» L 783.
Hasen-scharte. G.
Bee de lievre. F.
Hare-lip.

Usually, but not always, prevents suction, Brouzet,
Sur I'Education Medic, des. Enfans, IL p. 143.
C Bilobata. Lip bilobed, or doubly divided,
y Prolapsa. One or both lips striking broad and pro-
jecting.

GENUS III.

PAR/ESTHESIS.

Congenital misconstruction of the external organs of sense.
1. AUDiTus. Misformed organ of hearing.

tt Flacca. Lobe of the ear broad, loose, and pendent.
Proptoma auricularum. Sauv.

Said to be a common deformity among the natives
of Siam. — The source of the surname of Flaccus in
ancient Rome.
Flap-ear.

"A beetle-headed, /ap-ear'd knave." Shakesp.
^ Obstruens. Impeding the entrance of sound, from
imperforation or other cause.

Gen. III. Par^sthesis. nxfettrifirn, " sensus, imperfectus :" from
iru^utviccitftxi^ " in sensu fallor ; incorapos sum sensus." Theme
mvUfcftotty " sentio," whence jEsthetica, the name for Order II. of
Class IV.

416 * >' NOSOLOGY. [CL. VII.-OR. III.

Imperforate Ear. Youngs p. 414.
y Defectiva. The organization racomplete. .^

Cophosis congenita. Sauv. ^

. Surditas congenita. Alior.

Congenital Deafness.

2. OLFACTUs. - Misformed organ of smell.

« Obstruens. Impeding the entrance of scents, from im-

perforation or other cause.
C Defectiva. The organization incomplete.

3. visus. Misformed organ of sight.

x, Unoculata. Possessing only one eye.
Unoculus. Ami. Lat.
Monopia (fAevamei.) Auct. Grcec.
Cyclops.' — Monoculus. Plouquet.

See Xov. Act. Cur. Vol. VIII. obs. 7—Eller, Mem,

Gen. IV. Perosplanchnia. ilijgae-srAtfyjjvja, " viscus mancum :"
from Tnjgaj, " mancus, mutilus, captus parte aliqua corporis," and
o-srPiwypiiVM, " viscus." The latter part of the term is in the mouth
of every one.

Mutilations similar to these are also perpetually occurring among
plants. Sometimes from unfavourable climate or unaccordant soil,
the corol is imperfectly formed ; and the disease is then termed flos
mutilus. In cold seasons the corols are sometimes entirely wanting
in viola odorata and v. canina. Wildenow asserts that campanula
hybrida^ in some parts of Germany, is constantly without corols,
though it possesses them in France and Italy. We meet with a like
defect in various species of ipomcea, tussilago, and lychnis. The
common clove-pink (dianthus caryophillus) must often have been
seen by most persons with the scales of its calyx so much augment-
ed that the flower resembles an ear of wheat, and the corol never
appears. In like manner the stamens are often imperfectly formed,
and exhibit various mutilations : or the calyx is defective, or the
spur, in those naturally possessing this appendage, is entirely want-
ing

6. S. P. Genitune Defectiva. The testes commonly descend about
the seventh month of pregnancy ; and if the descent do not take
place before birth, it is usually attended with some pain and trou-
ble, and is frequently not completed till the approach of puberty.
But there are some tribes that are said to be naturally monorchid,
or possessed of only a single testis. Linneus made a distinct variety
of some African tribes of the genus homo on this account ; and the
following passage from Mr. Barrow's "Voyage to Cochinchina"
gives some confirmation to the idea. " Some of the men among
the Koras (a supposed mixed breed of Hottentots and Kaffers) were
observed to be monorchids ; but whether the defect was in conse-

GE. IV.3 NOSOLOGY. 417

de I'Academie de Berlin, 1 754 — Gilihert,- Adversar.
.'.<■'■ Pract. Princ. — Medinisches Wochenblatt, 1.785.

Pupillaris. Pupil incomplete in its power ef vision.

GENUS IV.

PEROSPLANCHNIA.

Congenital misconstruction of the viscera.
J. cRANii. Misconstruction of the head.

« Capitosa. Head enormously bulky : contents solid.
Capito. Atict, Lat,
Revausey. Arab.
Grosse-kopffg. G,
Jolt-head.
€ Hydropica. Head enormously bulky from dropsical
affection.

See Med. Com. Ed. VI. p. 422. — Remmeth : con-
nected with deficieucy of brain. Repeated punctures
appeared useful.
y-Cerebralis. Brain incomplete in quantity or organi-
zation.

Without cranium, and a fleshy mass instead of
brain, Vallisner, Oper. I. 330 — Soemmering. Abbil-
• dungen und Beschreibungen einiger misgeburten.
Mainz. 1791 — Without brain or medulla oblongata,
Dufour. Journ. de Med. xxxv. — Acephalous ; lived
eleven hours. Act. Med. Berol. Dec. I. viii — Lived
five days ; another case six days ; Plouquct.
2. CORDIS. The heart misconstructed or misplaced.

tc Perforata. The two ventricles communicating : lips
purple.
Cyania. Cricht,

Foramen ovale and ductus arteriosus open at seven-

quence of some operation submitted to while young on superstitioas
grounds, or occasioned by accident, or the sport of nature, does not
appear to have been ascertained." A similar defect has been no-
ticed among one or two of the wandering tribes on the skirts of the
Caucasus ; for which see KlaprotK's Travels in the Caucasus and
Creorgia, in loc. The atithor has at this time a healthy family
53-

■Ifr--..

4 IB 'K KGSOLOGT. [CL. Vll.-OR. III.

teen years of- age, Mem. Med. Soc, Vol. VI. Spry.
See also description of malformation in the heart of
an infant, Standert, Phil. Trans. 1805. p. 228. A
still more complicated case in Balllie's Morb. Anat.
PI. VI.
£ Translativa. Heart transposed to the right side.
y Expers. Heart totally wanting.

See Hezvson on the Lymph. Syst. Part II. p. 15.
There were other defects besides the total absence of
the heart. "The circulation had been carried' on
merely by an artery and a vein, whose coats there-
fore probably were muscular."
$ Multiplicata. Heart duplicate, or more than dupli-
cate.

Double : See D'AbouviUe, Amer. Phil. Trans. Vol.
!• V. — In a partridge, Tode, Annalen V. p. 1. In a
dog, Paullini^ Cynograph. cur. p. 43 — In a hen, Eph.
Nat. Cur. Cent. VIII. obs. 8 — Tripfe : found several
times in geese. Eph. Nat. Cur. passim.
3. ALVEi. The intestinal canal or its involucres misconstructed
or perverted.
«e Perforans. The intestines perforating the involucres.
See Calder Ed. Med. Ess. I. art. xiv. Intestines
appeared externally, having fallen through a perfora-
tion above the navel : child in health when born, but
died four days afterwards.
C Defectiva. Some of the parts wanting. See Din-
more, Lond. Med. Journ. XI. p. 339. Parietes de-
ficient. Similar defect, Act. Soc. Med. Hafn. I.
Saxtorph.
y Obstruens. Obstruction in the alvine passage, from
imperforation or other cause.

See Calder, as above, case 2. Fleshy tumour. —
Pylorus imperforate from a fleshy tumour seated on
it, and completely blocking it up: duodenum double :
child lived seven days after birth. See Calder, as
above, case 2.

under his care, in which all the sons, consisting- of three, were suc-
cessively born anorchid or monorchid : in the eldest, fourteen years
of age, both testes have now descended ; in the second, thirteen
years old, one has descended, the other is now passing through the
ring; in the youngest, twelve years old, there is at present no proof
of more than one testis.

€iE. v.] NOSOLOGY. 419

Imperforate Rectum. Baillie.

See Pappendorp von der verschliessung der aflcrsi
8. Leipz. 1783. ■*

4. HEPATis. Misconstruction of the liver.

Double. Schenck, lib. iii. sect. ii. obs. 8.

5. vesica:. Misconstruction of the bladder or urinary channel.

Bladder deficient. Duncan, Edin. Med, Journ.
IV. 403.

Urethra imperfect and imperforate : urine dis-
charged from a papilla near the navel : child oth-
erwise in health : age not mentioned. Moxmth.
Edin. Med. Ess. Vol. III. art. xiv.

6. GENiTUR^. Misconstruction of the genital- organs, or their

appendages.
u, Superflua. Organization superfluous or anomalously
multiplied.

Double uterus and vagina. Purcell, Phil. Trans.
1774, p. 472.

Double penis. Schenck, Hist. Monstror. Plonquci :
Von der Erbfahigkcit der kinder, p. 38.

Penis of enormous size. Memoires concernant les
Arts. 1672, p. 27. Wolff, Lect. Memorab. 1. 434.
C Defectiva. Organization incomplete.

One or both testicles defective. Generally from
emansion.

Prepuce or clitoris imperfect or wanting.
Vesiculae seminales confusedly united, and wanting
their excretory ducts. The necessary result of
this defect in an adult must be dysspermia, and
consequently agnesia. See Baillie, Morb. Anat.
Fasc. VIII. "pi. 1. fig. 2.
y Obstruens. Obstruction in the male or female pas-
sage from imperforation or other cause.
Atreta. Vog,

GENUS T.

PEROMELIA.

Congenital misconstruction or mutilation of the limbs.
1. DEcuRTATA. Limbs curtailed of their proper length.

420 NOSOLOGY. [CL. VII.^OR. III.

Artetiscus. Vog.

tc Brachii. Arms preternaturally abridged.

« Cruris. Legs preternaturally abridged.

2. TRUNCATA. Limbs or parts of a limb totally wanting.

» Capitis. Head totally wanting.
C Brachii. Destitute of one or both arms.
y Cruris. Destitute of one or both legs.
J Manus. Destitute of one or both hands*
€ Pedis. Destitute of one or both feet,
n Complicata. Destitute of various limbs.

3. coNTORTA. Limbs incurvated or confused in their organiza-

tion.
Fedaet. ^rab.
te Colli. Wry-necked.

Saur. Arab.
C Gibbosa. Hump-backed or hump-shouldered.

Akdab. Arab,
y Valga. Bow-legged or bandy-legged.

Akel. Arab.
3 Plauta. Splay-footed or splay-handed : having the
foot or hand turned inwards. Hence the name of
Plautiis, the Roman dramatic poet.
Fedegh. Arab.
i Loriformis. Club-footed or club-handed.

Gen. V. Peromelia. Tlt^^ofuXtx : from s-t)go$, as above, and ^8Ae$,
" membrum :" whence irnge^sAw. " mutilus, qui mutilatus, est mem-
bris."

2. It. P. truncaia Complicata. Miss Bevan, thus preternaturally
mutilated, exhibited herself a few years ago, in this metropolis: a
mere head and trunk, with the rudiments only of shoulders and low-
er limbs. She was about thirty years of age, of agreeable face,
form of body and manners; well educated; worked with her needle
by means of the tongue ; and painted miniature portraits with great
delicacy and close resemblance, by holding her pencil between the
right cheek and shoulder ; by the same contrivance she wrote a
neat running hand.

4. et. P. supcrjim Digitorum. The peculiarity is often propagated
to succeeding generations. See Mr. Carlisle's account of the family
of the Colbtirns of America: one of whom was lately exhibited in
this metropohs as a boy of extraordinary powers in arithmetical
calculations, Phil. Trans. 1814, p. 94. Some of the families of the
anc'ent Philistines appear to have possessed the same peculiarity,
2. Sam. xxi. 20. As also several among the Romans; for which
•ce PUoy, lib. xi. cap. 43. •" -.

GE. VI.] NOSOLOGY. 421

4, suPERFLUA. Limbs or parts of a limb superfluous.
Hyperartitiscus. Vog.

u Digitorum. Supernumerary fingers or toes,
f Crurum. Lower extremities superfluous.

Nates and lower extremities of a second issuing
from the abdomen of a first. Buxtorf. m Act. Helvet.
VII. 12.

GENUS VI.

POLYPERIA.

CoBgenital misconstruction of various parts or organs.
I. Promiscua. The parts or organs of one cavity confused
with those of another.
cc Translativa. Transposition of organs fi-om their
proper seat.

Abdominal viscera in the thorax. JMacauIay, Med.
Obs. Inq. I. 25.

Total transposition of the abdominal and thoracic
viscera; Sampson, Phil. Trans. 1674.
Q Vascularis. Inverted distribution of the arteries-
. Baillie,?]. 21.

Gen. VI. PoLYPERiA. IloAuwugw, from sreAt/j, "multus," and 7r»p»j,
•'• mutilus," as above : " multi-mutilatio."

Here again we meet with similar examples in the vegetable world.
Thus, in double or treble flowers (flos multiplicatus,) the petals are
preternaturally numerous, but not so as to interfere with the semi-
nal organs. In full flowers (flos plenus,) the petals are so multipli-
ed and crowded as to suppress the growth of the seminal organs,
and consequently to prohibit increase ; often, indeed, so crov/ded, a^
to burst the calyx. The first chiefly occurs in monopetalous flow-
ers, as primula, hyacinthus, polyantbes : the second in polypelatous
plants, as pyrus, fragaria, rosa, ranunculus, papaver, paeonia. Some-
times we find the spurs multiplied, and the petals completely want-
ing, as in aquilegia vulgaris, narcissus pseudonarcissus, and various
others. In other species of narcissus the petals sometimes remain
natural, and the nectarium is multiplied : and in other species of
aquilegia the petals are increased, and the spurs entirely wanting.
See Wihlftwrc. Elem. Botan. chap. vi. § 334, 335. . -. ,

422 NOSOLOGY. [CL. VIL— OR. III.

2. suPERTLUA. Superfluous organization general, or extending
to various organs.
a Biceps. Head double.

Double head with single body : one pair of hgs
and of arms : internal organization in many parts
double, and inclining to hermaphroditism ; Gibson.
Phil. Trans. 1810. p. 123. Fonrcroii, Medicine
Eclairee, I. 271. Haller 0pp. Tom."!.— Double
with double heart, Eph. J^ut, Cur. Dec. I. ann. i.
obs. 7.
5 Bicorpor. Body double.

Fe?c/'t;a/, Phil. Trans. 1752. 360; Twins coalescing
at the belly ; successiuily separated. Facio^ Helve-
tische vernimftige Wehmutter.

Twin-sisters, coalescing at the os sacrum; alive,
p.nd adults, Waldschmid^ Diss, de Sororibus gemellis,
&c. Kinon, 1709. Another case of adults, fFcf/f/tcr.
Thcs. Obser.

One. iicad, two bodies. Duverney, Comment. Pe-
tropoJ. III. 177.

Two bodies ; alive, Walther, Thes. Obs. 93.
y Convolvens. One individual enclosed within another.
G'. W. Youngs Medico-chir. Trans. I. 234.

2. 6. P. superjlua. The vegetable world is crowded with exam-
ples of oi'ganic superfluity or multiplied form. There are few
plants that do not occasionally exhibit double or triple seeds: every
kind of nut furnishes us daily with abundant examples. — So in Vol.
f. of the Jlmo-nitates Academica;^ we have an instance of a common
yellow toad-flax (antirrhinum Linaria) producing five nectaries from
a monopetolous pentandrous tube, instead of a single nectary from
a ringent tetrandrous flower, year 1744. Dissertatio de Peloria.
Resp. D. Rudburg.

2. S P. supe?-flua, Ilermaphroditus. Some kinds of animals, and
^'Specially in the lowest ranks, are natural hermaphrodites, as the
hirudo viridi^, or garden snail, and the fasciola hepatica^ or sheep
fluke. In animals having distinct sexes, whenever it occurs, it is
from a morbid or unnatural production of organs. This misconfor-
mation is perhaps to he traced in most tribes, but it is more com-
mon in some than in others ; and, in different instances, is to he met
with in all its (gradations, from the distinct sex to the most exact
• omhination of" male and female organs. In the h\iman species,
however, the last happens very rarely, and perhaps no perfect
specimen is to be found except in monsters exhibiting a double set
of other organs more or less completely developed, and which con-

"<3E. VI,]-- NOSOLOGY. 42i

A similar monstrosity in the vegetable world is to
be found in the Transactions of the Stockholm Aca-
demy, Vol. I. p. 414, under the title of Pomerantz med
ct inneslutit foster. It consists of one orange growing
within another. The fruit was exhibited to the Soci-
ety by Count Tessin.
^ Hermaphrodftus. Genital organs of both sexes in

one individual.
Hermaphroditus. Vog,
Khenshi. Arab.
Z witter. G.

See Parsons, Phil. Trans. 1751. p. 142. Ruysch,
Observat. Anat. n. 12. Gargon ct Fille hermaphro-
dites, &c. Paris 1772. C. Lips. Vol. XX. p. 632.—
Gentili, Relazione d'un individuo delle specie umana
fino all' eta di 13 anni creduio femmina, c poi reco-
nosciuto per maschio, &c. Firenze 1788.

Baillie, Trans. Soc. Medico-ch. Tom. 1. 189. Gib-
Son, Phil. Trans. 1810, p. 123; single body with
double head, the one a male, the other a female,
double heart and spine, and male and female genital
organs more perfect than usual.

sequently offer cases of imperfect germination, or an abortive at-
tempt to produce twins. In dogs and cats it is more frequent ; but
far more so in the horse, ass, slieep, and black cattle. There is a
very siriking character in the hermaphrodite of the ox kind. When
young, its general features are an intermixture of the bull and cow —
considerably resembling the spayed heifer or ox, properly so called :
and its flesh is usually ionnd of a finer flavour than that of the ox.
Its generic organs are more nearly allied to the female, but there
is no instance in which those of both sexes have been found perfect
in the same individual. 1 his epicene production is necessarily bar-
ren ; and as the Romans applied the term taura to some cows that
were barren, hereby giving to a masculine noun a feminine termina-
tion, it has been ingeniously conjectured that they were not unac-
quainted with the nature of the animal before us. In our own
country it is uniformly known by the name of a free-mariin. Its
production is also curious. If a cow have twins botiiofthe same
sex, or in other words, twin-bulls or twin-cows — each of the twins
is perfect in its make : but if the twins consist of a bull-calf and a
cow-calf, the bull-calf alone is perfect, and the cow-calf is uniformly
a free-martin. See Mr. J. Hunter's treatise on the subject, in his
" Observations on Animal Economy." p. 55.

424 M)SOLOGY. [CL. VII.-0R.11I.

3. DEFECTi VA. Defective organization general, or extending to
various organs.
« Nanus. The organization of the whble form distinct-
ly developed, but inordinately diminutive.
Zwerg. G.

Nain.' F. ^^

Dwarf. ;■*•■;**

Weighing, at fifteen years old, from twelve to thir- "
teen pounds only; and at the utmost only thirty-one,t \
inches high; crooked; Browning, Phil. Trans. 1791.'
278.
S Mola. General organization imperfectly and in-
distinctly developed.
Mezghet. £rah.

Mole. "Vi

Twin-mole without a heart. Le Cat, Phil. Traqs.
167. 1.

NOSOLOGICAL INDEX.

X

-The Classes and Orders are distinguished by Small Capitals, and the Genera
,. by Italics.

The letter A indicates that the term is an Arabic; F a French; and G a
German Synonym.

A.

Aberwitz, G. 236

Abortion, 319

Abortus, ib.

Abscess, 117, 118. 120

Abscessus, J 15

Absence of mind, 230

Abserdi, A. 299

Abstraction of mind, 231

Abwechselnd-fieber, G. 101

Acampsia, 262

Acdab, A. .420

Achor, 378

Achores, 378

Accouchement contre nature, F, 320

laborieux, F. ib,
Acna, 125
Acne, ib.
AcROTiCA, 354
Acrotismus, 264
Addephagia, 16
Adenophagia, 345
Adipsia, 14
Adstrictio, 31
^gritudo, 23

^STHETICA, 237

iEthiops, 196

Aftaden zihdan, A, 316

Agacenent des dents, F. 8

Agalactia, 301

Agalaxis, ib.

Agenesia, 308

Ageustia, 255

Jlgrypnia, 274

Ague, 101. 103, 104

Ague-cake, 65

Ahenje, A. 371

Ahul, A. 247

Aigreur d' estomac, F. 22

Akel, A, 420

54

Akhezet, A. 263

Akret, A. 314

Albino, 196

Albor cutis, ib.

Algor, 258

Alhemake, A. 164

Aiken, A. 80

Allotriophagia, 19

Alopecia, 379. 389, 390

Alp, G. 89

Alpliqs, 367

Alphosis, 195

Alusia, 225

Alysmus, 275

Amas, Pers. 328

Amaurosis, 245

Ambition, 223

Amblosis, 319

Amblyopia, 237, 238, 239, 240

Amenorrhoea, 295

Amentia, 234

American }'ellow-fever, 108

Amnesia, 234

Amor insanus, 224

sui, 223
Amphemerinus, 107, 108
Anabexis, 10
Anacatharsis, 82
Anaesthesia, 259
Anaphrodisia, 309
Anaptysis, 82
Anasarca, 151. 337
Ancyloglossum, 414
Anelus, 101
Aneurism, 213
Aneurisma, ib.
Anepithymia, 304
Angina, 89. 134
Angone. 13
Angst, G. 275
Anhelatio, 85

426

■INDEX.

Anhelation^ 85 «
Anilitas, 236
Aiikhyla, A. 410
Annulus repens, 374
Anosmia, 253, 254, 255
AncBa, 236
Anorexia, 17. 25
Anstossen, G. 79
Anthrasia, 176
Anthrax, 124
Antipathia, 276
Antipathie, F. ib.
Antipathy, ib.
Anxietas, 275
Anxiete, F. 275
Anxietudo, 224
Anxiety, 275
Apalotica, 395
Aphelxia, 229
Aphonia, 75. 77
Aphoria, 313
Aphronia, 292
Aphtha, 168
Aphthes, F. ib.
Apocenosis, 22. 349
Apoplexia, 292
Apoplexie, F. 292
Apoplexy, 292
Apogeusis, 255
Apospasma, 410
Jpostema, 114
Aposteme, 115
Appeiit bizarre, F. 19
Appetite canine, 16
Appetite morbid, 15
Apsychia, 282
Arbedet, A. 276
Ardeur in coeur, F, 21
Ardor, 258
Area, 390
Arek, A. 274
Areknak, A. 355
Arrhoea, 295
Arthritis, 151. 155
Arthrosia, 151
Asaphia, 79
Asef, A. 375
Ascarides, 46. 48, 49
Ascites, 340
Ascite, F. 340
Askites, ib.
Asphyxia, 264. 288
Astasia, 275

Asthenia abstinentiuni, 18
Asthenia deglutitionis, 13. 81
Asthma, 86, 87. 89
Asoupisseinent, F, 291
Atecnia, 314
Atheroma, 331
Atrophia, 189
Aitritio. 398

Augensternverengerung, G. 244

Avarice, 224 , -^

Auditus acrior, 2fi0 " " ,,..

difficilis, ib. -

imiuinutus, 251 ■ ,

Augenentziindung, G, 145

Aukile, A. 217

Auri fames, 224

Aurigo, 56. 393

Avekeb, A. 308

Autaigia, 91. 257. 266

Ausatz, G. 367

Auswartskenrung des augemlieds, G.
249

Azeb, A. 389

Bacchia, 126

Baillement, F. 270"

Ballismus, 271

Bambalia, 79

Baras, A. 367, 368

Barrenness, 314

Battarismus, 79

Bauch-fluss, G. 37

Bave, F. 11

B«c de lievre, F, 415

Begayeraent, F. 79

Behr, A. 85

Bein-bruch, G. 408

Bek, Turc. 413

Bekym, A. 75

Beladet, A. 235

Bemiihung zum brechen, G. 24

Benat-allil, A. 166

Beriberi, 273

Ber)ue, F. 241

Betise, F. 234

Bex, 82

Bezoar, 41

Bezoardus, ib.

Biccho, Portug. 384

Bikhudlik, A. 291

Black vomit, 59

Bladdery fever, 171

Blsesitas, 80

Blasenaus-schlag, G. 171

Blasenstein, G. 353

Blear-eye, 147

Blebs, 372

Bleeding at the nose, 186

Blehung, G. 23

Blenorrhcba, 298

Blepharoptosis, 249

Blinzen der augenlieder, G. 269

Blessure, F. 39G

Bloody urine, 187

Bluten, G. 186

Blut-bpeyen, G. 187

INDEX.

427

Boak, A. 367

Boil, 123

Bombus, 23

Bones, flexibility of, 333

fiagilily of, ib.
Borborygmus, 23
Bougeons, F. 125
Bradyspermatismus, 312
Branks, 134
Bredouillement, F. 79
Breeze-fly, 52

Brennerschlaus-schlag,-G, 167
Biennen im magen, G. 21
Broken-wind, 86
Bronchitis, 134
Brown-study, 232
Bruck, G. 402
Bruise, 400
Brulure, F. 399
Briistbraune, G. 89
Bubo, 121
Bubonocele, 402
Bucnemia, 207
Bulimia, 16
Bulimos, ib. .
Burn, 399
Busyr, A. 54
Boutons, F. 358
Byzeban, Ptrs. 76

■ C.

Cacatoria, 37

Cachexia icterica, 57

Cachexies, 182

Caducus, 235

Caligo, 243, 244

Calculus (enterolitbus,) 43
intestinal, 44
de la vessie, F. 353
vesica, ib.

Calus, F. 387

Callus, ib,

Calvities, 389

Campsis, 409

Cancer, 198

Canine madness, 279

Capistrum, 262

Capito, 417

Caput obstipum, 261

Carbuncle, 124

Carbuncular exanthern, 177

Carbuncled face, 126

Carbunculus, 124

Carfunckel, G. ib.

Carcinoma, 198

Carcinus, ib.

Cardialgia, 20. 22

Cardiogmus, 214

Carditis. 138

Caries, 215. 218 *

Carphologiai 270

Carpotica, 318

Caroncle, F. 386

Caruncle, ib.

Caruncula, ib.

Carus, 287, 288. 291, 292

Catacausis, 208

Catagma, 408

Catalepsia, 290

Catalepsie, JP, 291

Catalepsy, 291

Catameniorum fluxus, 296

Cataphora, 291

Cataract, 244

Catarih, 148

Catarrhus, 82. 85. 147. 347

Cathemerus, 102

Catochus, 265. 290

Catotica, 336

Cauma, 109. 133

Causis, 399

Causus, 108

Ceinture dartreuse, F. 374

Cele, 401

Cenotica, 294

Cephalsea, 279

Cephalalgia, 280

Cephalitis, 133

Cephaloxia, 261

Cernhnus, 93

Cercosis, 317

Cerion, 378

Champignon, F, 67

Change of voice, 78

Charbon, F. 124

Chartre, F. 197

Chassie, F. 147

Chaudpisse, F. 299

Chauliodus, 3

Chauvete, 389

Chemosis, 145

Chicken-pox, 170

Chiggres, 384

Chilblain, 131

Chiques, F. 384

Chivalry, 226

Chlorasma, 304

Chlorose, F. 304

Chlorosis, 303, 304

Choiras, 197

Cholelithia, 61

Cholelithus, ib.

Cholera, 38

Cholirica, 59

Chololithus, 60

Chorea, 271

Choreomania, ib.

Chordapsu?, 27. 141
.> Chrysomania, 224
'■ Chute du Ibndement, F. SS

^\tf-:

438

Pliutc de la luette, ^. 13 '■
de la matrice, F, S16

CiNETICA, 260-

Cirsus, 214

Citta, 19',

Clap, 299

Clasis, 408

Clavellee, F. 382

Clavus, 387

Clonus, 267

Clou, F. 119.246

Cochemar, F. 89

CffiLlACA, 1. 37

Colebiilla, 385

Cold, 72

in the head, 149

Coldness, 258

Colic, 27

Devonshire, 28
painter's, 28
Poictou, ib.
wind, 30

Colica, 26

Laponica, 52

Coliquc, F. 27

Coma, 288. 291, 292

Combustura, 399

Comitialis, 285

Commedones, 385

Concussio, 400

Concussion, 400

Conductiones, 261

Congenital deafness, 416

Consumption, 192

Constipatio, 32

Contractura, 262

Contracture, F. 262
Contusio, 400
Contusion, ib.
Conlusura, ib.
Convulsio, 284
Convulsion, ib.
Convulsion-fit, ib.
Convulsiones, 261
Cophosis, 250. 253. 416
C'oproslasis, 31
Co(jueluchc, F. 84
Cor de picds, F. 387
Corns, 387
Cornua cutanea, 370
Corpulence, F. 326
(Corpulency, 326
Coryza, 70, 148
CostivenesF, 32
Cough, chin, kin, or kind, 84
chronic, of old age, 83
common, 82
dry, 83
hooping, 84
"oup d' arme a fen, F. 396
de sanfT, F, 292

•INDEX.

Coupei
Cours

F. 126

Cours de ventre, i^. 37
Courbature, F. lOO

Couvtn halipnp. F. 35

Courbature, F. 100
Courte haliene, F. 85
Cow-pox, 169
Crab-louse, 383
Crachement de sang, F. 187
Cramp, 265
Crampff, G. ib.
Crampus, 265
Craziness, 220
Credulitas, 235
Credulity, ib.
Cremason, F. 22
Crepitus, 23
Cretinismus, 194
Crithe, 122
Cross-birth, 320
Crotaphus, 280
Croup, 136
Croute de lait, 378
Crusta lactea, 378
Crystalline-pocI^, 176
Cura, 224
Cut, 396

Cutaneous blush, 357
Cyclops, 417
Cynanche, 134, 135
Cynorexia, 16
Cyrtosis, 193
Cytisma, 373

Dahus, A. 127

Dal fil, A. 207

Dandriff, 366

Danse de St. Guy, 272

Dark spots before the eye?, 243

Dartre, F. 373, 374

encrountee, jF". ^374
Daus salcb, A. 389
Day-sight, 238
Dazzling before the eyes, 242
Deafness, 253
Deaf-dumbness, 77
Decline, 190

Defluvium capillorum, 389
Defluxio, 37
Degoiit, F. 24
Delirium, 220. 222
Delilik, Ture. 234
Dcmm, A. 402
Demmel, A. 123
Dementia, 222
Demence, F. ib.
Denhel, ./?. 121
Dentition, 3

Depot laiteux, F. 120. 151
l^epressio, 41(1

JNDEX/'

V29

Depression, 410
Desiderium, 224
Desasossiego, Span. 275
Desperatio, 224
Desperation, ib.
Despondency, ib.
Devar, A. 281
Diabetes, 348
Diachalasis, 412
Dialysis, 396
Diaria, 100
Diarrhoea, 36
Diary fever, 100
Diastasis, 411
Dicke, G. 326
Dik, J. 108
Dinus, 281
Diplopia, 243
Dipsosis, 14
Dislocation, 410
Distensio, 400
Distillatio, 71
Distrix, 389
Daemonotnania, 227
Dotage, 236
Double hearing, 252
Double ouie, F. ib.
Douleur du fondement, F. 53

d' oreille, F. 133
Doximania, 223
Dragoneau, F. 385
Dragsinta, Suecic, 272
Drey-tagig fieber, G. 103
Drifif, Sax. 98
Drivelling, 11
Drop serene, 245
Dropsy, 337

Driisenkrankheit, G. 207
Dublet, J. 115
Dumbness, 75
Dummheit, 234
Durete d' oreille, .F. 251
Dwarf, 424

Dysesthesia, 235,237. 249. 255, 256
Dysecoea, 250, 251, 252
Dysecoia, 250
Dyscyesis, 437
Dysemesia, 24
Dysenteria, 32
Dysenteric, F. 36
Dysentery, 36
Dysitienorrhoea, 295
Dysopia, 238, 239, 240
Dyspepsia, 15. 25
Dyspermatismus, 312
Dysphagia, 11
Dysphonia, 77
Dysphoria, 274, 275
Dyspncea, 84

catarrhalis, 83
Dtsthetica, 182

Dystocia, 318 : ■
Dysspermiay 312
Dysuria, 347.353

K,

Ear-ache, 133

Ecdoia, 398

Ecartement des os, F. 411

Eccyesis, 322

EccRiTicA, 325

Echauboulure, F. 375

Echarde, F. 397

Eckel, G. 24

Eclampsia, 284

Ecorchure, F. 132. 398

Ecphlysis, 370

Ecphronia, 219

Ecphyma, 64. 66. 150. 328. 386

Ecplexis, 280

Ecpyesis, 376

Ecrouelles, F. 197

Ecstacy, 291

Ecstase, F. 291

Ecstasis, ib.

Ecthyma, 376. 380

Ectropium, 249

Eczema, 375

Eczesma, 362

Edema, 337

Efflorescence benigne, F. 359

Eintagages fieber, G. 99

Eiteraug, G. 246

Eiter-blassen, G. 122

Eiter-beule, G. 119

Eiter-finnen, G. 376

Eiter-geschwulst, G. 115

Ekrah, A. 24

Elatio, 225

Elephas, 204

Elephantiasis, 203. 205

Elcus, 216

Elf-siddenne, Sax. 89

Elephantanaussatz, G. 206

Emesis, 23

Emaciation, 189

Emmixium, 156

Empathcma, 223

Emphlysis, 167

Emphractica, 64, 65

Emphragma, 14. 385

Emphyma, 327

Emphysema, 342

Empresma, 132

Emprosthotonos, 263

Empneumatosis, 343

Emptoe, 186

Emptoys, 186

Empyema, 118

Empyesis, 173 , . .'

430

Enanthesis, 162 % • .
Encausis, 399
Enchefrenement,' jP. 72
Encystis, 331 ,

Enecia, 109
Engbriistigkeit, G. 85
Evgelure, F. 131
Enkebas, ^. 32
Ennuie, F. 229 !:,,

Entasia, 260

Enteritis, 141 ■ .

Enterica, 1
Entero-cele, 402
Enter olithus, 40
Entero-epiplocele, 402
Enthesis, 406
Entonia, 261
Entorse, i?'. 400j
Entziickung, G. 290
Entziindung der blase, G. 144
darmen, 141
hertze, 139
leben, 142
langen, 137
magens, 140
miltz, 143
mutter, 144
nieren, 143
Envie, F. 413
Envie de vomir, F. 24
Enuresis, 349
Epanetus, 107
Ephelis, 392
Epheraera, 99
Ephialies, 38
Ephidrosis, 355, 356
Epicrosis, 391
Epilepsia, 285
Epilepsy, 285
Epimelium, 326
Epinyctis, 373
Epiphora, 10. 145
Epiplocele, 402
Epiploitis, 139
Epistaxis, 186
Epizoolia, 382
Epreinte, F. 54
Epulis, 9

Eraillement, F. 249
Erbrechen, G. 24
Erethismus, 89. 275. 279
Ereuxis, 23
Ergot, F. 216
Erkaltung, G. 148
Erosion, 132
Ertofltung, G. 215
Eructatio, 23
Ertihash, Jj. 398
Erysipele, F. 128, 173
Erysipelas, 173
Fri/lhema, 12H .
■' %■

Eshera, A. 362
, Esr, ^. 345
Essera, 362
Eterniiement, F. 268
Etisie, F. 190
Etiska, A. 337
Eshal, A. 37
Esquinancie, F. 134
Evanouissroent, F. 282
Eversion of the eye-lids, 249
Exangeia, 212
Kxangia, ib.
Exania, 54

EXANTHEMATICA, 157

Exanthems, 157
Exanthesis, 357
Exarthrema, 410
Excoriatio, 398
Excoriation, ib.
Excoriatura, ib,
Excrescentiae, 328
Exoryste, 317
Exoneirosis, 234
Exormia, 358
Exostosis, 332
Expectoratia, 82

solida, 136
Extra-uterine fetation, 322

Faifait, A.il

Faim, F. 16 •*'

Fainting-fit, 282 '^■■'"

FaJlende-sucht, G. 235

Falling down of the fundament, 55

womb, 316
Falling-sickness, 285
Falsch-sehen, G. 241
False conception, 324
False sight, 241
Fasciola, 49
Fatuite, F. 234
Fatuity, 234
Favus, 378
Febris, 93. 99

alba, 304

continens, 109

continua, 109

dysenterica, 36

inflammatoria, 109

intermittens, 101

lenta, 108

maligna. 111 .

putrida, ib.

puerperalis, 112

remittcns, 107

rubra, 164
Fedegh, A. 420
Feiste, G. 326

■if'*

INDEX.

431-

Felon, 127

Felure, F. 409

Fetation, extra-uterine, 322

Fevak, ^. 268

Fever, 92

diary, 96

eruptive, 157

hectic, 108

jail. 111
• »-, inflammatory, 109

intermittent, 101

nervous, 111

putrid, ib,

puerperal, 112

scarlet, 164

simple, 100

vesicular, 171

Feu de St. Antoine, F. 173
Feuerflecke, G. 130
1^. :'• Feuergiirtel, G. 374
• ■ "Feuermahl, G. 413
Fickleness, 235
Fidgets, 275
Fievre, hectique, F. 108

intermittente, 101
Fievre, ortie 167

quarte, 104

quotidienne, 102

rouge, 164

scarlatine, 164

tierce, 103

vesiculaire, 171
Fisch-schuppen-aussatz, G. 370
- , f isb*skin, ib.
;• ' Fissura, 409

Fissura capillorum, 389
Fissure, 409
Flap-ear, 415
Flatulency, 23
Flatulentia, 23
Flatus, 22
Flea-bites, 383
■ . Flecke, G. 391
. ' Fleckerothe flecke, G. 362
'.."•" Fleisch-driise, G. 386
Fleurs blanches, F. 298
Flooding, 312
Fluke, 49
Fluor-albus, 298
Flux, bloody, 36
Flux du sang, F. 36
Folic, F. 220
Folly, 235
Forgetfuluess, 235
Formica ambulatoria, 374
Fractura, 408
. Fracture, ib.
Fragile vitreum, 333
Fragilitas, ib.
Framboesia, 181
Frantzosen, G. 200

Frat, G. 131 •
Freckles, 392
Frenk zehemeti. A, 200
Fress-lust, G. 17
Fressenkeit, G. 17
Fress-sucht, G. 16
Fret, 131

Fretillement, F. 275
Frieselblattern, G. 168
Frog-tongue, 14
Fungus haeinatodes, 198
Furoncle, K"123
Furunculus, 123
Furor, 308

Gadfly, 50

Gahnen, G. 270

Galactia, 301

Gale, F. 380

Galactirrhoea, 301, 302, 303

Gallstein, G. 61

Gall-stone, 61

Ganglion, 332

GangrcETia, 214

Gangrene, 214

Gaping, 270

Gasavet, A. 224

Gastritis, 140

Gastrocele, 404

Gastrodynia, 22

Gedrif, G. 98

Geiflfern, G. 11

Geilkeit, G. 307

Genetica, 294

Gelbe-haut, G. 393

Gelbsucht, G. 57

Gerstenkorn, G. 122

Gesasfall, G. 55

Geskye, A. 282.

Geschwar, G. 119.216

Gespaltete haare, G. 389

Ghem, Pers. 228

Ghemm, A. 228

Gicht, G. 293

Glaucoma, 243

Glaucosis, ib.

Gleet, 299

Globus hystericus, 13

Gloria, 223

Glossocele, 13

Glucksen, G. 268

Glus, 347

Gluttony, 17

Goggle-eye, 247

Gonorrhoea, 299

Gordius, 51. 385

Gourmandie, i^. 17 ■

Gout, 90. 155 : i

Goutte rose, F. 126 • .^ '

432

Gianchio, Ital. 265

Gratelle, 381

Giaue-staar, G. 244

Graukopf, G. 389

Giavedo, 72. 149

Gravel, 353

Gravelle, F. ib.

Graviditas molaris, 324
ovarii, 322
tubalis, ib.

Gray-hairs, 389

Green sickness, 304

Gries, G. 364

Griess in den nieren, G. 352

Grillenkopfheit, G. 228

Grimmen, G. 27

Grind, G. 378

Orison, F. 389

Grossen-durst, G, 14

Grosse-kopfif, G.417

Gfosse-panse, G. 326

Grutum, 364

Guinea-worm, 385

Giildene ader, G. 54

Gum-boil, 119

Gutta rosea, 126
Serena, 245

H.

Haarigkeit, G. 389
Haarkrankenkeit, G. 388
Haematemcsis, 187
H^MATICA, 92

Haematidrosis, 356

Haematuria, 187

Haemodia, 7

Hsemoptoe, 186

Hajmoptysis, 186. 191

Hamorrhagia, 186

crueiita, 54
mucosa, ib.

Ha;morrhois, 54. 183

Hair-worm, 51. 385

Hal6, F. 392

Hallucinatio, 225. 227

Hararet, j9. 258

Hare-lip, 415

Hardness of liearing, 251

Harn-llus, G. 349

Harm strange, G, 346

Harte-rothe, G. 123

Hasbct, ^.165

Hasef, ^. 368

Hasem-schartc,G, 415

Harvest-bug-bite, 384

Haupl-schuppen, G. 366

Haufn^vehc, G. 280

HautgeWfctw, G. "

Haut-insenC)^ (J'.C

]'^ix.\

.*k-

360

.382

Hautrbihe, G. 128
, Hautschwirrung, G. 29S

Head-ache, 280

Heart-ache, 224
burn, 199
sinking, 22

Heat, 258

Heat-eruption, 375

Heben, Jl. 340

Hectic fever, 108

Hectica, ib.

Hectique, ib.

Helminthia, 45, 46

Hemeralopia, 238

Heuiicrania, 208

Hemiplegia, 29R

Hemitritaeus, 107

Hemm, .4. 275

Hemmai mehrikeh, A. 10&
murbau, 104
mushelleshe, lOS

Hemorrhage, 186

Hemorrhagie, F. ib.

Hemorrhoide, F. 54

Hemret, A. 173

Hepatitis, 142

Hepatocele, 404

Heres, .4. 376

Herkeshet, A. 400

Hermaphroditus, 423

Hernia, 401, 402

Hernia humoralis, 144

Hemic, F. 402 V '" "^-'t^JM
fausse, F. 238 ^^

Herpes, 373, 374, 375. 377 •

Hers, .4. 400
llessat, ^. 353
Hesitation, 79
Hiccough, 268
Hidroa, 375
Hieranosos, 284
Hieropyr, 127
Hirnfieber, G. 133
Hiriiwuth, G. ib.
Hirsuties, 389
Hirudo, 52
Hives, 171
Hoquet, F. 268
Hordeolum, 122
Hornhautaposiom, G. 246
Horn-pock, 176
Huft-wche, G. 154
Hulas, Jl. 190
Hunden-hungcr, G. 16
Hund-tollcit, G. 279
Hiineraug, G. 387
Hur, Pcrs. 289
Husr, «-?. 32
Husten, G. 82
Hydarthrus, 157
Hydrachnis, 171

•■^^^J^l*

^J^Ji^Xf-'

433

Hydrocele, 342
Hydsocephale, F. 338
Hydioceplialus, 338
Hydrometra, 342

• Hyilionosus, 100
Hydropedesis, 355
Hydrophobia, 279
Hydrophobie, F. ib.
Hydrophthulmia, 246
Hydiopes, 336

, Hydrops, 336. 342
Hydrops siccus, 343
Hydropisie, F. 337. 342
Hydrorachitis, 339
Hydrothorax, 339
Hyperoum, 414
Hyperuresis, 349
Hypochondrias, 227
Hypochondriasis, 228
Hypochondrie, F. 228
Hypochondrisin, ib.
Hypochyma, 244
Hypopyum, 246
Hyposarca, 64

m Hyposarcidius, 337
Hypostaphyle, 13
Hysteria, 285
Hysteric-fit, ib.
Hysteritis, 144
Hysterophyse, 344
Hystriacis, 388

Jaundice, 57

Jaunisse, F. ib.

Ichnophonia, 79

Ichorous exanthem, 167

Icterus, 56

Icthyasis, 369

Icthyiasis, 370

Idiotism, 236

Jealousy, 223

Jecur akend, Pers. 65

Jecur fcssadi, Pers. 142

Jedrie, J. 174

Jejunium, 18

Jema, »4. 120

Jenun, .4. 222

Jesbe, ji. 291

Ignis, sacer, 129, 130. 180

Jiminerat, ^. 177

Jirsam, Jl. 138

lidet, ^. 363

Ileus, 27

Ileus hajniatites, 211

illusion, 225

Imaginary sounds, 252

Imbecility, 234

55

Imbecillite, F^ 234
Immobilitas pupillse, 245
, Impetigo, 368. 376, 377
Iniposthume in the Ear, 119
Impotence, male, 311
« Impotentia, 310
In)puissance, jf^. 311
Incendium spontaneum, 208
lnconsta.nce, F. 235
Inconstantia, ib.
Incontinence d' urine, F. 343
Incontinence of urine, ib.
Incontinentia urinse, 349
Incube, F. 89
Incubus, 88
Indigestion, 25
Inedia, 18

Inepuisance d' ejaculation, F. 312
Inflammation edematous, 128

erysipelatous, 129
gangrenous, ib.
of the bladder, 144
bcwils, 141
eyes, 145
heart, 1,39
kidney, 143
liver, 142
lungs, 137
spleen, 143
stomach, 141
testicles, 144
womb, ib^
Snflammations, 113
Inflammatory blusl^, 128
Inflatio, 30
Inflation, 343
Influenza, 149
Infreddatura, lial. 148
Inquietudo, 274
Insecten-stick, G. 397
Insanity, 226
Insomnie, F. 275
Intermittens, 101
Intermittent fever, ib.
Intertrigo, 131
Joint-ache, 152
Jolt-head, 417
lonthus, 125
Iracundia, 223
Iris* 374

IrkMedini, ./?. 385
Irrationality, 234
Ischiadum malum, 154
Ischias rheutnaticum, ib.
a sparganosi, 151
Ischiocele, 404
Ischuria, 345
Itch, 380

bricklayer's, 377
grocer's, 377
uiangv, 381

-■ ' ^^

434

IN

Djftk.

Itch, rank, 381

watery, ib.
Itching, 257
Judam, ^. 203
Junun, Jl. 133
Juzam, ^. 206

K.

Kabus, Jl. 89

Kafes, J. S!44

Kalak,^, 275

Kalte-biss, G. 299

Kalte-geschwulst, G. 130

Kasho, A. 154

Kazech, ^. 261

Kebz, ^. 32

Khefakan, ^. 269

Kedazesh, ^. 139

Kefijet, Ji. 287

Kehlsucht, G. 134

Keichen, Jj. 86

Kejik, Ttirc. 363

Kel, ^, 373

Keleb, ^. 277

Kerch, ^. 131

Kerk, ^. 216

Kervet, ^. 402

Kesret, ^. 461

Khabbet, ^. 83

Khafa, ^. 289

Khal, ^. 413

Khemkheniet, ^. 78

Khenauk, .4. 134

Khensi, ^. 423

Khora, ^. 206

Khure, ^. 215

Khyarjek, ^, 121

Kibe, 131

Kieferaussatz, G. 123

Kindsflecken, G. 165

Kinr'.spocken, G. 174

King's evil, 197

Kleinaussatz, G. 368

Klopffen, G. 269

Knotc, G. 328

Knoten, G. 353

Kreji, A. 24

Koleng, ^.27

Koltek, j9. 388

Kouba, ^. 364

Kraitzc, G. 380

Krebs, G. 198

Kricbelkrankheit, G. 214. 272

Kropf, G. 197

Knim-hals, G. 261

Kurtzcr-atiiern, G. 85

Kurtsithtigkeit, G. 240

Kusofjvl.Sl

Labium leporinum, 415

Labour lingering, 320
morbid, ib,
" Labour-show, 298

Laceratio, 401

Laceration, ib.

Laetitia, 223

Lagnesis, 307

Lagostoma, 415

Lahm, A. 328

Lallatio, 80

Land-scurvy, 211

Lascivious madness, 308

Lascivite, F. 307

Lanifendegicht, G. 153

Lausigkeit, G. 333

Lax, 37

Leberflecke, G. 392

Leichtglaublickeit, G. 235

Leichtsinnigkeit, G. ib.

Leipopsychia, 282

Leipothymia, 282

Lenticula, 392

Lentigo, ib.

Lepidosis, 365. 370

Lepra, 206. 367, 368

Lepriasis, 367

Leprosie, F. 367

Leprosy, 206. 367

Lerema, 235

Lerze, Per*. 271 ' ..

Lethargus, 291 >l,.l

Lethargy, ib.

Leucasmus, 391 ' * "

Leuce, 368

Leucophlegmatia, 337
Leucorrhoea, 297
Levy, A. 400
Lichen, 361, 362, 363 *
Licheniasis, 359
Lienteria, 37
Limosis, 15
I^inguse exsertio, 13
Lipi)itude, 147
Lippitudo, ib.
LispeJn, G. 81
Lisping, ib.
Lithia, 352
Lithiasis, 334. 352
Loathing, 24
Locked-jaw, 262

Lodgement of matter in the chest, lU
Loemus, 178
Lolling-tongue, 13
Long round worm, 48
tape worm, 49
thread worm, 48
Long-fasting, 18

INDEX.

43^

Long-sight, 239
Longiug, 224
Looseness, 37
Louchotte, F. 247
• Lousiness, 383
Low-spirits, 228
Loxarthrus, 411
Loxia, 261
Lues, 199
Lmnbago, 154.
Lumbricus, 48
Lupia, 331
Lupus, 21S
Laxation, 410
Laxatura, ib.
Lygmus, 268
Lyssa, 277

M.

Macies, 189

Macula lata Platen, 130
Maculas cornese, 243
Madness, 222
Maggot-pimple, 126
Mehl, A. 391
Mahleigrimmen, G. 28
Mai a la tete, F. 28D
Mai caduc, F. 285
Mai de dents, F. 6

de la rose, F. 206

de me^«, F. 285
...ide piinta, F. 138
■'' de sole** F. 206'

des ardens, F. 180
Malacia, 20
Malacosteon, 333
Maladie des prisons, F, 111
imaginaire, F. 228
noire, F. 59
pediculaire, F. 383
soucie, F. 224
Malis, 382

Malum hystericum, 285
Mangel-durst, G. 15
Mania, 220, 221, 222
Manie, F. 222
Manquement de soif, F. 15
Marasmus, 189
Marisca, 54
Marcores, 189
Massledigkeit, G. 19
Mastodynia, 120
Matted-hair, 388
Matuhlik, Jl. 234
Maiizel, A. 320
Maw-worm, 50
Measles, 165
Medend, A. 46
Megraine, F. 280

Megrim, 280 '
Megs, A. 36'"
,Mekhas, A. 320
Mekser, A. 403
Melceria, 59
Melalet, A. 228
Melancholia, 220. 228
Melancholie, 220
Melancholy, ib.
Melas, 36iS
Melasma, 380
Melasictenis, 59
Meliceris, 332
Memoriae debilitas, 234
Meraouk, A. 25
Menshen-fiendschaft, G. 229
Menorrhagia, 187. 295, 296. 29S
Menses antevertentes, 296
retention of, 295
suppression of, ib.
Menstruation, excessive, 296
laborious, 295
profuse, 296
vacarious, ib,
Mentagra, 123
Mental extravagance, 226
Mesenteritis, 140
Mesket, A. 324
Meskim, A. 321
Mksotica, 325
Metamorphosia, 242
Metritis, 144 '

Metrocelis, 413
Metrorrhagia, 187
Mictus cruentus, ib.
Milch-streichen, G. 151
Mildew-mortification, 216
Miliaria, 167
Miliaris, 168
Miliary fever, ib.
Milium, 364
Milk-spread, 151
Millot, F. 168
Misanthropic, F. 229
Misanthropy, ib.
Miscarriage, 319
Misgeburth, G. ib.
Mismenstruation, 294
Mola, 324. 424
Mole, 424
Mollities ossium, 333
Molluscum, 332
Monoculus, 416
Monopia, ib.
Morbilli, 165
Morbicalculosi, 352
Morbus pilaris, 385

regius, 57
Moria, 234
Morosis, 234
Morpiones, 383

43G

SuDtK,

Mors apparens, 288 "*
Morsus ventriculi, 21
Movt de chien, F^ 40
Mo.ta, 171
Mortification, 214
Mosghet, ^. 424
Mother's-maik, 413
Mouth-watering, 10
Mue de la voix, F. 7S
Mum, ^. 91
Mumps, 134

Mundschwanchen, G. 168
Musca cibaria, 52
Muscae volitantes, 242
Mutitas, 75, 76
Mutite, F. 77

Mutter-beschwening, G. 285
Mutter-mahle, G. 413
Myitis, 153
Myle, 324
Myodesopia, 242
Myopia, 240
Myopiasis, ib.
Myositis, 153

N.

Nachtblindkeit, G. 233
Nacht-mannlein, G. 89
Nievus, 413

Nagel-geschwar, G. 127
Nain, 424
Nanus, ib.
Nasitas, 78
iVasur,.4. 387
Nausea, 24
Nauz, Jl. 307
Necrosis, 216
Neirendis, 8
Nehem, ji. 16
Nehva, ^. 270
Nekeb, A. 380
Nekes, A. 333
Nemesh, A. 392
Wemim, A. 252
IVephralgia, 352
Nepiiritis, 143
Nervous deafness, 251

faintin^^ fit, 282

quinsy, 13
Neshr, A. 373
Nettle-rash, 167
Network before the eyes, 242
Neuralgia, 265
Nkcrotica, 219
Nou.-tiissure, F. 400
Nezaruk, J}- 284
Niaiscrje, F. 235
itictilatio, 269
Niescn, O. 268

Night-mare, 89
Night-pollution, 234
«•- Nighi-sight, 238
Nigredo a sole, 392
Nickris, A. 155
Nirles, 374
Noctanibulatio, 233
Node, 332
Nodosia,8
Noli me tangerc, 218
Nouage, F. 194

de la cornea, F, 243
Noueure, F. 194
Nufas, A. 349
Numbness, 259
Nyctalopia, 233
Nyctalopie, F. ib.
Nyctegersia, 233
Nyctobasis, ib.
Nymphomania, 307, 308
Nystagmus, 247, 269

Gben und unten purgiren, G. 39

Obesitas, 326

Obesity, ib.

Oblivio, 234

Oblivion, 235

Obscuratio corneae, 243

Obstipatio, 32

Obstipitas, 261, 262 t •■?,• ^^

Obstructio, 406 ' 'jj — -

Ocatoposis, 12

Odaxisnuis, 2

Odontalgia, 1

Odonliu, ib. i

Odontiasis, 2

Odoratus deperditus, 2.'',4

Oedema, 13. 87. 337

Oedoplosis, 315

Oesophagismus, 12

Oestrus, 50-

Ohmacht, G. 282

Ohr-schmurtz, G. 133

Olfactus amissio, 253

OU'actus aciior, 254

Olophonia, 414

Onia, A. 243

Omentitis, 139

Oneirodynia, 89. 233

Onirodynia, 233

Onyx, 246

Opako cornea, 243

Ophiasis, 390 ,

Ophtlialmia, 145

Opiithfilmie, /'• ib.

Dphthalmites, ib.

Ophthalniy, ib.

Opfsthotonos, 263

INDEX.

43:

Oreillons, F. 134
Orgastica, 303
Orgeolet, F. 122
Oithopnoea, 13. 85. 90
Oscheophyma, 342
Oscheocele, 342. 402
Oscitatio, 270
Ossificatio, 334
Ossium recessus, 411
Osteosarcosis, 334
Osthexia, 334
Otas, A. 268
Otalgia, 120. 133
Otitis, 133
. Oubii, J". 235
Ouie engourdie, F. 252

tendre, F. 259
Oxyopia, 238
Oxyphonia, 73
Ozoena, 73

P.

Pain in the side, 114
Palmus, 24. 28. 269
Palpitatio, 269
Palpitation, ib. ^

Palsy, 293
Panaris, 127
Pandiculalio, 270
Pantry-fly, 64
Pantophsbki, J879
Papula, 358 .-
Papulae, ib.
Papulous-skin, ib.
Parabi/smu, 62
Paracusis, 2i9. 252
Paracoe, 249
Paracyesis, 318
Par(esihcsis, 415
'Para-fieusis, 255
Paiaglossa, 414
Paraglosse, 13
- Paralysis, 293

rachialgica, 2S
Paralysie, F. 293
Paramenia, 294

Paraplegia, 293

Paraphimosis, 122

Paraphonia, 77, 78

Parapsis, 256
'Paiasitistnus intestinalis, 4S

Parasynanche, 135

Paristhmia, 134

Paristhmitis, 135 •

Parler du nez, F, 78

Parodynia, 319

Paroncea, 235

Paronychia, 127

Paroniria. 23^

Paropsis, 237
Parosmis, 253
Paroslia, 333
Parotis,. 120
Porotitis, 134
Partus dificilis, 320
Paruria, 344
Passing of gall-stones, 62
Passio boayina, 382

iliaca, 27
Passion, ungovernable, 223
Parulis, 119
Pelagra, 206
Pellagra, ib.
Pemphigus, 171
Pemphinfiodes, 168
Peripneumonia, 137
Peripneumonie, F. ib.
Peripneumony, ib.
Perirrhcea, 349
Peritonitis, 139
Pernio, 131
Peromelia, 419
P erosphlandinia , 417
Perte d'odorat, F. 254

de sang de femme, F, 29S
Pertussis, 83
Perverse hearing, 252
Perversio capitis ossium, 411
Pervigilium, 274
Pest, G, 178
Peste* F. ib.
Pestilentia, ib.
Pestis, ib.

Petechise sine febre, 210
Petecchial scurvy, 210
Petite verole, F. 174
Pfniigel, G. 71
Phagadrena, 16
Phagifina, ib.
Phallorrhoea, 299
Phantasma, 241
Philautia, 223
Phimosis, 121
Plegmalia, 337

lactea, 150

dolens, ib.
Phlegmatorrhagia, 71'
Phlegmone, 118
Phi.ogotica, 113
Phlogotice, 132
Phlyctsena, 377
Phhjsis, 126. 376
Phoenigmus, 210. 32^
Phoenicismus, 165
PUOJVICA, 70

Photophobia, 238
Photopsia, 242
Phrenesie, F. 133

rtlRENICA, 219

Phrenitis, 133

43i5

UOiCX.

Phrensy, 133

Phtharma, 243, 244

Phthiriasis, 382^ rf"'

Phthisie, F. 192

Phthisis, 191, 192

Phygethlon, 121

Phyma, 122

Phymatosis, 386

Physconia, 63. 66. 68, 69. 327

Physometra, 344

Pian, 182

Pica, 18

Pierre au fiel, F. 61

Piles, 54

Pimple, common, 375

Pin-eye, 245

Piquure, F. 397

Pisseiiient de sang, F. 187

Pityriasis, 366

Plague, 179

P-laited-hair, 388

Playe, F. 396

Plethora, 184

Pleuralgia, 90

Pleurisie, F. 138

Pleuritis, 138. 154

Pleurisy, 138

Pleurodyne, 90. 154

Plica, 338

Plique, F. 388

PwEtJMATICA, 70

Pneumatosis, 343

Pneumonica, 81

Pneusis, 82

Pnigma, 85

Podagra, 155

Podalgia, ib.

Poecilia, 393

Pollution involuntaire, F. 234

Polydipsia, 14

Polype, F. 73

Polyperia, 421

Polypus, 73

Polypus vaginse, 317

Polypus uteri, 317

Polysarcia, 326

Pompholyx, 371

Porphyra, 209

Porrigo, 377, 378. 390

Pousse, F. 85

Pox, 200

Pregnancy, morbid, 318

Presbyopia, 239

Presbytia, 239

Preying care, 224

Priapism, 261

Priapisnie, F. 261

Priapismus, 261

Prick, 397

Prickly-heat, 362

Ffide, 223

. Procidentia uteri, 317,

\ Proctalgia, 53
t ■ Proctica, ib.
Proctocele, 55
Production, uvulaj, 13
Pneotia, 305
Profusio, 188. 210
Prolapsus ani, 55

vaginae, 316, 317
vesicsE, 316
uteri, ib.
uvulae, 13
Protuberant eye, 246
Prurigo, 363, 364
Pruritus, 257
Pneumonia, 137
Pneumonitis, ib.
Presentation, preternatural, 320
Psellismus, 79
Pseudtesthcsia, 260
Pseudoblepsis, 241-
Pseudocyetis, 324
Pseudo-syphilitic disease, 203
Psoas, 117
Psoas abscess, ib.
Psora, 380
Psoriasis, 363
Psorophthalmia, 146
Psydracia, 125
Ptarmus, 268
Ptyaiismus, 10
Pulmonaria, 137
Punctura, 397 ,*.-_ ^

Puncture, 397 .-., 1 .

Purging and vomiting, -39
Purpura, 164. 168. 209
Pursiness, 85
Push, 119
Pustula, 376
Pustulae, ib.

Pustulous exanthem, 173
Pye-balled negroes, 394
Pyrectica, 92
Pyrosis, 22
Pyuria, 347

Q.

Quartaine, F. 104
Quartan ague, 104
Quotidian ague, 102
Quinsy, 134

R.

Rabies, 277, 278
Rache fairneuso, F. :

seche, F. ib..
Radafet, j9, 386

J79

INDEXi

435

Radoterie, F. 236 -

Rage, F. 277

Rain-bow-worm, 375

Ralement, F. 75

Ranula, 14

Raphania, 272

Rash exanthem, 163

Rattling in ttie throat, 75

Raucedo, 77

Raucitas, 77

Ravaglio, Ital. 171

Raush, ./4.27I

Recessus ossium, 412

Recollectionis jactura, 235

Red-gown, 359

Red-gum, ib.

Reined, A. 147

Remet, A. 215

Remittent fever, 103

Renversement de la matrire, F. 316

de la vessie urinaire F.
316
Restlessness, 275
Retching, 24
Retention d'urine, F. 345
Revausey, Ji. 417
Reverie, F. 230
Revery, 230
Rhachia, 194
Rhachialgia, 28
Rhachitis, 194
Rhegvia, 400^
Rhencus, t4fi
Rheiifna, J4>
Rheumatism, 153
Rheumatismus, ib. .
Rheumatisme chaud, F, ib.
Rheume, F. 149
Rhinophonia, 78
Rhochmos, 75
Rhoncus, 74
Rhypia, 375
Rickets, 194
Ring-worm, 374
Riquets, F. 194
Rootvont, Belg. 362
Rosalia, 164
Rose-rash, 357
Roseola, 357
Roth-gesicht, G. 126
Rothlauf, G. 173
Roth-nase, G. J26
Roth-pfinnen, G. 125
Rothe, G. 359
Rothe-punkt, G. 210
Rothe-ruhr, G. 36
Rougeurs, F. 126
Rougeole, F. 165
Ruaf, A. 186
Rubeola, 165
Rubula, 181

Ruck-gratkrankheit, G. 194

Rugh, A. 23

Running at the noS|| 7t'

Rupia, 375

Ruptura, 401

Rupture, ib.

Saamen, A. 252

Saamenfluss, G. 300

Sahik, A. 145

St. Antony's Fire, 173

St. Vitus's Dance, 271

Salacitas, 307

Salacity, ib.

Salivatio, 10

Salivation, ib.

Sanguifluxus, 186

Sarcoma, 328, 329, 330, 331
niesenlerii, 67
Epulis, 9
narium, 73

Satiriasis, 307

Saur, J. 420

Scabies, 368. 380, 381

Scale skin, 365

Scan, 366. 368. 376, 377, 378

Scalled head, 378

Scaly tetter, 368

Scharbocken, G. 212

Scharlachaufschlag, G. 164

Scarabaeus, 50

Scarlatina, 164

Scarlet Fever, ib.

Schaufhusten, G. 83

Schielen, G. 247

Schlaf-spitzieren, G. 233

Schlieren, G. 121

Schlag, G. 292

Schullul, A. 386

Schwartze galle, G. 59

Schvveys sucht, G. 101

Schwachheit, G. 234

Schwermuth, G. 220

Schwindsucht, G. ipS. 192

Schwachmutigkeit, G. 311

Sr.hiefen-sehen, G. ^'O

Schlaflosigkeit, G I

Schnarchen, G. tlK^

Schrunden, G. 409

Schupfen, G. 72

Schuppen, G. 366

Schiitheln, G. 400

Schwammformig aussatz, G. 181

Schwindel, G. 281

Schwisblattern, G. 375

Scelotyrbe, 271

Sciatica, 154

Sclopetoplaga, 396

440

Scorbut,F. 212 »'

Scorbutus, 212

Scordin?ma, 270,

Scotoma, 282^'"' ♦

Scrophula, 197

Scurvy, 209, 210, 211

Scybalum, 44

Sea-scurvy, 212

Sechercss de poitrine, F. 83

Serlao, ^. 279

Seliu, .^. 225

Seiteii-sticlie, G. 91

Seiten-wehe, G. 138

Sejli-dem, .4. 186

Seklet, ^. 292

Seket, 319

Selau, ^. 409

Seles, ^1, 349

Se^f-love, 223

Self-conceit, 223

Semna, ^, 304

Sentiinentalism, 226

Separation of bones, 411

Seram, 2R5

Serataun, .4. 198

Seres, A. 310
Serkond, ^. 282
Shebek, J. 307
Shebkerat, .4. 233
Shekyhat, J. 280
Shiiine, J. 378
Shingles, 374
Short-breatli, 85
Short-sighl, 240
Sibbens, 203

Sickness of the stomach, 23
Sidoratio, 133
Sifflement, F. 78
Singultus, 268
Silat, A. 197
Sila, /I. 328
Silliness, 235
Siriasis, 133
Sitis Morbosus, 14
Sivvens, 203
Skue-sight, 240
Slavering, 11
Sleep, apparent, 291
.Slet'p-walking, 233
Sleep-talking, 233
Sleeplessness, 274
Small-pox, 174
Smell, 253, 254

acute, 254
obtuse, ib.
loss of, ib.
Sneezing, 268
Snivelling, 72
Snoring, 75
Soal, yj. 32
Saol, A.M'

Soda, 21 • 'y

Solf, excessive, F. 14 *

., -' Somnambulism, 233

Sortnnambulismus, ib.

Somnolency, 291

Sommersprosse, G. 392

Soubresaut des tendons, F, 270
t Soolal, J. 192

Soporosi, 286

Sore-throat, 135

Soreness, 257

Souris, F. 269

Sortie de la laugue, JF". 13

Spasm, 261

Spastici, ib.

Sparganosis, 150. 301

Sparks before the eyes, 242

SpermorrhKa, 300

Speaking through the nose, 78

Speechlessness, 75

Spnichel fluss, G. 10

Sphacelus, 215

Sphacelismus, 133

Spina ventosa, 334

Spina bifida, 339

Spinola, 3;;9

Spi.ajvchnica, 56

Spitting of Blood, 186 " '

Splenitis, 143

Spilosis, 391

Spilus, ib.

Squainmae, 365 ,,,

Squinancy, 134 -■" »;i%s^ -.

Squinsy, 134 ^ _^^-^''"''

Squinting, 247 ; • ■"'^'\^=$ -

Stamlen, G. 79 "'■

Stammering, ib.

Staphyloma, 246

Starcker-husten, G, ;84

Stecker-zunge, G. J3

Stkreotica, 407

Sterilitasj 303

Sterilite desfemmes, F. 314

Sterilite male, F. 309

Sterility female, 314

Sternalgia, 89

Sternutatio, 268

Sterteur, 75 ■

Stertor, 74

Stick, G. 396

Slich, 91
Stiff-nec-k, 261

Stiilicidium iiarium, 71

Stoinacace, 21 1

Stomach-disease, 15

Stone in Uifi bla((dcr, 353
-•Y Stone-pock, 125 ,
•' Stopjiage 6f urine, 345

, , . Stopi'ung, G. S'i
•. ■ Siottoni, G. 79

Strabisiints, 247

N

ISTPEX.

44 1

Strain, 400

Strainiflg, 54

Stragiiria, 346. 34&

Strangury, 346

. Strenima, 400

Stereotica, 406
/'Streckung, G. 270
• Stretching, ib.

Strophulus, 358

Struma, 196

Stadium inane, 232

Stultitia, 235

Stiilzwung, G. 54

Sturaniheit, G. 76

Stupiditas, 234

Stupidity, ib.

Stupor, 259

Stuttering, 79

Stye, 123

Stypsis, 32

Suaniinento, Span. 282,

Suasarcosis, 67

Subat, A. 291

Subsultus, 270

Subluxatio, 411

SiKla, ^. 220

Sudamina, 362

Sudoi> 355

Sudor Anglicus, lOQ'

Suette, F. 101

Suft'ocatio, 85

Suffusio, 241, 242

Summer-ra$li, 39&,

Sun-huri^ S9»

Supl 'Af^22Qi ^ * ,

Superbia-, 223

Superannuation, 236

Surdit.ls, 253

Surdite, ib.

Suspended animation, 289

Susurrus, 252

Suzish, v4. 399

Sweating sickness, 101

Sweet-spittle, 11

Swimming of the head, 281

Swine-pox, 171

Swoon, 282

SwuUe, G 387

Sycosis, 123

Synanche, 134

Synclonus, 270

Syncope, 89. 282

Sjnezesis, 244

Synoca, 109

Synochus, 109. Ill

Syphilis, 199

Syrigma, 78 '♦'•

Syrigmus, 252

Systatica, 273

Syspasia, 283

Systremma, 265

56*

Tabes, 190

;Taches de rousseui*, F.'392
Tactos acrior, 257 * ''*

''imminutus, 259
Tsedium vitae, 228
Tffinia, 48
TsBsa, Pers, 275
Tag-blindkeit, G. 23»
Tagig-fieber, G. 102
Tarns, A. 296
Tape-worm, 49
Taraxis, 145
Tartar of the Teeth, 9
Taste, 255

acute, 255

obtuse, 256
Taus, Jl. 265
Taublieit, G. 253
Taye, F. 243
Teethine;, 3
Teigne,>. 37?
Teneritudo, 257
Tenesmus, 53
Tenk nefes, Jl. 86
Teiitigo penis, 261
Terniinthus, 124
Tertian ague, 103
Tertianus, 103
Teshennug, A. 262
Testudo, 332
Tetanus, 263. 265
Tetaitaeus, 104
Tetartophya, 105
Tetter, 373. 376, 377. 379'
Tezauf, .■y. 321
Thirst, morbid, 14
Thlasis, 410
Thlasnia, 399
Thorheit, G. 235
Thrush, 168
Tic, 262

Tic douloureux, F. 260
Tick, 384

Tiefsinnigkeit, G. 231
Tinea, 377
Tintanimet, Jl. 79
Tippel-beul, G. 121
Tiraillement, F. 270
Tollheit, G. 222
Tongue-tie, 414
Tonic spasm, 261
Tonici, ib.
Tonos, ib.
Tooth-ache, 6
Tooth-edge, 8
Tooth-rash, 360
Tormina, 36
Torpor, 287
Torpor paiicreatis, 6G

/i

\

■V:

442

Tournoyeinent de tete, F. 281

Toux, F. 82

Trance, 291 _

Tianclie;'s rles enfans, F. 30

Transport, 223

Traulotes, 80 ^

Traurigkeit, G. 228

Tremblement, F. 271

Trembling, 271

Tremor, 271

Trichoma, 388

Trichosis. ib.

Trichuris, 48

Tricocepiialus, 48

Trismus, 262, 263. 2GQ ,

Tritaeophya, 104. 103

TritffiLis, 103

Tfomos, 271

Trousse-galant, F. 39

Tuber, 323

Tuberculum, 328

Tiimeur blanche, F. 156

Tumor, 328

Tumour, 328

Tussis, 82

Twinkling of the eye-lids, 269

Twitching of the tendons, 270

TycHiCA, 395

Tympania, 343

Tympanite, F. 345

Tympany, 343

Typho'les, 110

Typhomania, 291

Typhus, 110

V.

Vaccina, 170
Vaccinia, 169
Vapours, 228
Varicella, 170
Variola, 174
Varix, 214
Varus, 125
Vauket, A. 19
Ubel-horen, G. 251
Vedaf, Ji. 300
Vege-ome fasil, A. 154
Veki, ^.251 '
VentositP, F. 23
Ventriculi inflanmiatio, 140
Veibrennung, G. 399
Verdriisslichkeit, G. 228
Verdunkluug der glasernen feutichkei
G. 244

der hornhautj 243
Vergesslichkoit, G. 235
Yerum, A. 189
Venninatio, 16

l^tJEX.

/"'

^1^'

k

Verole volante, F. 170
Verolette, F. 171
Verrenckung, G. 4.00
' Verruca, 386
Verriie, F, ib.
Vers, F. 46
Vevzerhung, G. 190
Vertige, F. 281
Vertigo, ib.
Vesamia, 220. 222
Vesaniae, 220
Vesicular fever, 171
Viertagig-fieber, G. 104
Visas acrior, 238
diurnus, 238
juvenum, 240
nocturnus, 238
Vitiligo, 367. 391
Ulcer, 216
Ulcere, F. 216
Ulcus, 216
Unachteu kindspocken, G. 170
Unfrukibarkeit, G. 314
Ungovernable passion, 223
Unoculus, 416

Unrecht, G. 252 ■ : '

Unruhe, F. 275 jf • • *■'

Unsinnigkeit, F. 220 "^—i ■

Unverdaulicbkeit, G. 25
Uiiveinunfft, F. 235
Unverstand, F. 234
Unzeitigc-geburth, G. 319
Vornendi conamen, 24 <:

Vomica, 118 /♦ ^JiU \

Voraissement, F. 2% •^'9J^^

de sang, F. 18? ?■ •
Vomiting, 24

of blood, 187
Vomituritio, 24
Vomitus, ib.

crue«tus, 187
Voracite, F. 17
Voracity, ib.
Uredo, 166
Urine, stoppage of, 345

incontinence of, 349
Uroplania, 351
Urticaria, 166
Uteri inflatio, 344

invereio, 316

prolapsus, ib.

retroversio, ib.
Vue couche, F. 240
courte, F. ib.
longue, F. 239
Vulnus, 396 .

W.

Wahnsinnigkeit, G. 236

./•

'.'./
«*

n

Wart, fiSS

WarfciSfC 386

Wasserblassen, G. 371

Wasserblattern, G. 370

Wassersucht, G. 337
,^. Water-blebs, 372
.■•?,«\Vater-;brash, 22
Y Water-pox, 171

Water-qualm, 22

Weariness of life, 229

,Web eye, 243

Weisse-flusse, G. 298

Weissehaut, G. 196

Weiss-schwellen, G. 156

Welk, 126

Wen, 331

Whepzing, 75

White-gown, 360

Whit&gum, ib.

White-^pwelling, 156

Whites, 298

Whitlow, 127

Windige-wassersucht, G. 343

Wind dropsy, 340

Wind-grimmen, G. 30

Wischtel-zopff, G. 388

WitleSsness, «35

tl^mb, faUi'nl down of, 316
inverted, ib.
polypus of, 317
rotrovertedj 316

Worm, tape, 49

Worm, thread, 4^

imnif lib V

IND&X>

Mf

woMjiM^

Wound, 396
Wrath, 223
Wrench, 400
Wunde, G. 396
Wurmsucht, G. 4Q

'\

Yara, A. 396
Yawning, 270
Yaws, 181
Yehem,.4. 234
Yerekaun, ^. 57

Zahne-stumpf, G. 8
Zahn-pein, G. 6 .
Zahnen, G. 3.
Zameh, ^. 119
Zatal-bein, A. 1^
Zefer, jl. 122
Zekh, A. 387
Zelotypia, 223
Zemherir, A. 258
Zemin, A. 293
Zeminlik, Turc. 293
Zeryr, A. 59
Zerzerretes, G. 400
Zipperlein, G. 155
Ziras, A. 2

Zirknirschung, G. 400
Zischen, G. 78
Zitterich, G. 361
Zittermahl, G. 373
Zittern, G. 271
Zona, 374
Zoster, ib.
Zukam, A. 148
Zulekkhet,.^.154
Zurat, A. 23
Zwerg, G. 424
Zwitter, G. 423
Zyger angen, G. 147

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